Individual provider Active NPI

Alice Wade Noles, LCSW

  • Clinical Social Worker
  • Fort Worth, TX
National Provider Identifier
1700282068
Registry record updated Jan 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
41966 Issued in TX
Practice address
1300 S University Dr Ste 306
Fort Worth, TX 76107-5746
Phone
(844) 824-8775
NPI assigned
Nov 14, 2014
Last updated
Jan 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2023

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 41966 TX Primary

Addresses

Primary practice location

1300 S University Dr Ste 306
Fort Worth, TX 76107-5746

Mailing address

9004 County Road 1128
Godley, TX 76044-3407
Phone (817) 229-7486

Other practice location 1

9004 County Road 1128
Godley, TX 76044-3407
Phone (817) 229-7486

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
I20150107001874 TX Practitioner - Clinical Social Worker 0941523443 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Progressive Behavioral Health, PLLCGroup PAC ID 4486794906, 366 clinicians

Practice addresses (Care Compare)

1300 S University Dr
Suite 306
Fort Worth, TX 76107-5746
Phone (844) 824-8775

431 E State Hwy 114
Suite 140
Southlake, TX 76092-4412
Phone (844) 824-8775

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
41966TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological Services of North Texas, PLLC CurrentSince Aug 29, 2016 Accepting new patients
Progressive Behavioral Health, PLLC Clinical CurrentSince Jun 28, 2022 Accepting new patients

Locations

1300 S University Dr
Ste 306
Ft Worth, TX 76107
Phone (817) 410-7300

700 NE Loop 820
Ste 200A
Hurst, TX 76053
Phone (817) 905-1277

431 E State Highway 114
Ste 140
Southlake, TX 76092
Phone (817) 751-7802

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1415923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1700282068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9004 COUNTY ROAD 1128",
            "city": "GODLEY",
            "state": "TX",
            "postal_code": "760443407",
            "telephone_number": "817-229-7486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 S UNIVERSITY DR STE 306",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761075746",
            "telephone_number": "844-824-8775"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9004 County Road 1128",
            "address_purpose": "LOCATION",
            "city": "Godley",
            "state": "TX",
            "postal_code": "760443407",
            "country_code": "US",
            "telephone_number": "817-229-7486",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOLES",
        "first_name": "ALICE",
        "middle_name": "WADE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-14",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "41966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.