NPIMap

Organization Active NPI

Family Service Assn of Lubbock, Texas, Inc.

  • Clinical Social Worker
  • Lubbock, TX
National Provider Identifier
1659541308
Registry record updated Mar 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
33072 Issued in TX
Legal business name
FAMILY SERVICE ASSN OF LUBBOCK, TEXAS, INC.
Practice address
22 Briercroft Office Park Ste 10
Lubbock, TX 79412-3007
Phone
(806) 747-3488
Fax
(806) 747-3219
NPI assigned
Mar 10, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2008

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

Authorized official

Name
Bryan Moffitt, LPC
Title
Executive Director
Phone
(806) 747-3488

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 33072 TX Primary

Addresses

Primary practice location

22 Briercroft Office Park Ste 10
Lubbock, TX 79412-3007

Mailing address

22 Briercroft Office Park Ste 10
Lubbock, TX 79412-3007
Phone (806) 747-3488

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240522000101 TX Part B Supplier - Clinic/Group Practice 9133107980 Receives reassigned benefits from 6 practitioners
Practice locations: Lubbock, TX

National Provider Directory

National Provider Directory

Locations

22 Briercroft Office Park
Ste 10
Lubbock, TX 79412
Phone (806) 747-3488

Practitioners & affiliated clinicians

Practitioners 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1205107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205107200000",
    "number": "1659541308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 BRIERCROFT OFFICE PARK STE 10",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794123007",
            "telephone_number": "806-747-3488",
            "fax_number": "806-747-3219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 BRIERCROFT OFFICE PARK STE 10",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794123007",
            "telephone_number": "806-747-3488",
            "fax_number": "806-747-3219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY SERVICE ASSN OF LUBBOCK, TEXAS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-10",
        "last_updated": "2008-03-10",
        "status": "A",
        "authorized_official_last_name": "MOFFITT",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "806-747-3488",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "33072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2008; 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.