Individual provider Active NPI

Kiante Vaughn Conger, LMSW

  • Clinical Social Worker
  • Fort Worth, TX
National Provider Identifier
1609627504
Registry record updated May 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
110963 Issued in TX
Practice address
6300 John Ryan Dr
Fort Worth, TX 76132-4122
Phone
(817) 922-5995
Fax
(817) 922-5955
NPI assigned
Mar 28, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Clinical Social Worker 1041C0700X 110963 TX Primary

Addresses

Primary practice location

6300 John Ryan Dr
Fort Worth, TX 76132-4122

Mailing address

PO Box 33568
San Diego, CA 92163-3568
Phone (855) 223-7123

Other names 1

  • Kiante Vaughn Lemons Former name

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
110963TXMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1711584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779753600000",
    "number": "1609627504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33568",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921633568",
            "telephone_number": "855-223-7123",
            "fax_number": "619-374-7134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 JOHN RYAN DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761324122",
            "telephone_number": "817-922-5995",
            "fax_number": "817-922-5955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONGER",
        "first_name": "KIANTE",
        "middle_name": "VAUGHN",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-28",
        "last_updated": "2026-05-26",
        "certification_date": "2026-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "110963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIANTE",
            "last_name": "LEMONS",
            "middle_name": "VAUGHN",
            "credential": "LMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 May 26, 2026; 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.