Active NPI
Mary Lovegren
- Clinical Social Worker
- Ft. Worth, TX
National Provider Identifier
1588095756
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 11914
- Practice address
- 4230 Locke Ave
Ft. Worth, TX 76107 - Phone
- (817) 602-0209
- Fax
- (817) 870-9996
- NPI assigned
- Dec 12, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 11914 | TX | Primary |
Addresses
Primary practice location
4230 Locke Ave
Ft. Worth, TX 76107
Mailing address
4230 Locke Ave
Ft. Worth, TX 76107
Phone (817) 602-0209
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11914 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1386806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1490659200000",
"number": "1588095756",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4230 LOCKE AVE",
"city": "FT. WORTH",
"state": "TX",
"postal_code": "76107",
"telephone_number": "817-602-0209",
"fax_number": "817-870-9996"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4230 LOCKE AVE",
"city": "FT. WORTH",
"state": "TX",
"postal_code": "76107",
"telephone_number": "817-602-0209",
"fax_number": "817-870-9996"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOVEGREN",
"first_name": "MARY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-12-12",
"last_updated": "2017-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "11914",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ft. Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.