NPIMap

Organization Active NPI

The Oaks Life Center, PLLC

  • Clinical Social Worker
  • Fort Worth, TX
National Provider Identifier
1588036370
Registry record updated Apr 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
33494 Issued in TX
Legal business name
THE OAKS LIFE CENTER, PLLC
Practice address
6012 Reef Point LN
Suite C
Fort Worth, TX 76135-7008
Phone
(682) 312-8184
Fax
(817) 238-1232
NPI assigned
Oct 20, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Julie B Cosgrove
Title
Credentialing
Phone
(682) 209-5662

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 33494 TX Primary

Addresses

Primary practice location

6012 Reef Point LN
Suite C
Fort Worth, TX 76135-7008

Mailing address

6012 Reef Point LN Ste C
Fort Worth, TX 76135-2056
Phone (682) 312-8184

Other practice location 1

8621 Mid Cities Blvd # 300
North Richland Hills, TX 76182-4711
Phone (682) 312-8184

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190410001073 TX Part B Supplier - Clinic/Group Practice 3173862182 Receives reassigned benefits from 3 practitioners
Practice locations: Fort Worth, TX

National Provider Directory

National Provider Directory

Locations

6012 Reef Point Ln
Ste C
Fort Worth, TX 76135
Phone (682) 312-8184

8621 Mid Cities Blvd
Ste 300
North Richland Hills, TX 76182
Phone (682) 312-8184

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1445299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554336000000",
    "number": "1588036370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6012 REEF POINT LN STE C",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761352056",
            "telephone_number": "682-312-8184",
            "fax_number": "817-238-1232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6012 REEF POINT LN",
            "address_2": "SUITE C",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761357008",
            "telephone_number": "682-312-8184",
            "fax_number": "817-238-1232"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8621 Mid Cities Blvd # 300",
            "address_purpose": "LOCATION",
            "city": "North Richland Hills",
            "state": "TX",
            "postal_code": "761824711",
            "country_code": "US",
            "telephone_number": "682-312-8184",
            "fax_number": "817-238-1232",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THE OAKS LIFE CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-20",
        "last_updated": "2019-04-04",
        "status": "A",
        "authorized_official_last_name": "COSGROVE",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "682-209-5662"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "33494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.