Active NPI
Chuck Staats, LCSW
- Clinical Social Worker
- Wichita Falls, TX
National Provider Identifier
1629077995
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- S06187
- Practice address
- 1808 Rose St
Wichita Falls, TX 76301-4219 - Phone
- (940) 723-4488
- Fax
- (940) 723-0446
- NPI assigned
- Jul 19, 2005
- Sex
- Male
- 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 | S06187 | TX | Primary |
Addresses
Primary practice location
1808 Rose St
Wichita Falls, TX 76301-4219
Mailing address
1808 Rose St
Wichita Falls, TX 76301-4219
Phone (940) 723-4488
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 064152401 | Medicaid | TX | |
| 123721 | Other | TX | SUPERIOR |
| 00558M | Other | TX | BLUE CROSS BLUE SHIELD |
| 125047 | Other | TX | MHN MANAGED HEALTH NETWOR |
| 5241400 | Other | TX | AETNA BEHAVIORAL HEALTH |
Other names 1
- Charles R. Staats
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S06187 | TX | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121731200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349740800000",
"number": "1629077995",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1808 ROSE ST",
"city": "WICHITA FALLS",
"state": "TX",
"postal_code": "763014219",
"telephone_number": "940-723-4488",
"fax_number": "940-723-0446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1808 ROSE ST",
"city": "WICHITA FALLS",
"state": "TX",
"postal_code": "763014219",
"telephone_number": "940-723-4488",
"fax_number": "940-723-0446"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STAATS",
"first_name": "CHUCK",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-07-19",
"last_updated": "2012-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "S06187",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "064152401",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SUPERIOR",
"identifier": "123721",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "00558M",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MHN MANAGED HEALTH NETWOR",
"identifier": "125047",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA BEHAVIORAL HEALTH",
"identifier": "5241400",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "CHARLES",
"last_name": "STAATS",
"middle_name": "R.",
"credential": "LCSW",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Wichita Falls, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.