Individual provider Active NPI

Christopher Blaine Meador, LCSW

  • Clinical Social Worker
  • Plano, TX
National Provider Identifier
1679537724
Registry record updated Mar 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
21056 Issued in TX
Practice address
3608 Preston Rd
Ste 140
Plano, TX 75093-8649
Phone
(214) 674-8806
NPI assigned
Apr 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 21056 TX Primary

Addresses

Primary practice location

3608 Preston Rd
Ste 140
Plano, TX 75093-8649

Mailing address

PO Box 864047
Plano, TX 75086-4047
Phone (214) 674-8806

Other identifiers 1

IdentifierTypeStateIssuer
063927001MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040804001443 TX Practitioner - Clinical Social Worker 5294706008 Reassigns benefits to 1 organization
Practice locations: Plano, TX

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3608 Preston Rd
Suite 140
Plano, TX 75093-8649
Phone (214) 674-8806

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
21056TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Momentum Psychological Services, PLLC Clinical CurrentSince Apr 1, 2019 Accepting new patients
Full Circle Counseling & Consulting, PLLC Clinical PastSince May 31, 2017 Accepting new patients

Locations

3608 Preston Rd
Ste 140
Plano, TX 75093
Phone (214) 586-0066

520 Central Pkwy E
Ste 234
Plano, TX 75074
Phone (214) 586-0066

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520294400000",
    "number": "1679537724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 864047",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750864047",
            "telephone_number": "214-674-8806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3608 PRESTON RD",
            "address_2": "STE 140",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750938649",
            "telephone_number": "214-674-8806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEADOR",
        "first_name": "CHRISTOPHER",
        "middle_name": "BLAINE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-14",
        "last_updated": "2018-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "21056",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "063927001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.