Andrew Duckworth, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149023515 Issued in IL

Practice address

1315 S Adams St
Fort Worth, TX 76104-4404

Phone

(833) 484-6359

NPI assigned

Oct 26, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1603670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1609476134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 S ADAMS ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044404",
            "telephone_number": "833-484-6359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 S ADAMS ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044404",
            "telephone_number": "833-484-6359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUCKWORTH",
        "first_name": "ANDREW",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-26",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149023515",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXONOMY",
            "identifier": "101YM0800X",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julia Dubose, APRN
• Lisa A. Duchamp, M.D.
• Yadranko Ducic, MD
• Amanda Duck, PA-C
• Gregory Machen Duck, PA
• Cesar P Duclair, M.D.
• Carly Scanlon Duclos, MS, RDN
• Asgar A Dudhbhai, MD
• Jordan Elizabeth Dudley, ACNP-BC
• Rebecca Nicole Dudley, PA-C

• Clinical Social Worker in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.