Individual provider Active NPI

Ashly Nicole Huffstatler, LCSW

  • Clinical Social Worker
  • Plano, TX
National Provider Identifier
1710448154
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
62248 Issued in TX
Practice address
4825 Alliance Blvd Ste 150
Plano, TX 75093-5577
Phone
(844) 824-8775
NPI assigned
Mar 28, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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 62248 TX Primary

Addresses

Primary practice location

4825 Alliance Blvd Ste 150
Plano, TX 75093-5577

Mailing address

4825 Alliance Blvd Ste 150
Plano, TX 75093-5577
Phone (844) 824-8775

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
I20190416000893 TX Practitioner - Clinical Social Worker 4880935006 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1105 Jefferson Ave
Waco, TX 76701-1212

1211 W 22ND St
Suite 406
Oak Brook, IL 60523-2169

180 Sycamore Ave
Apt 121
Brentwood, CA 94513-1104

308 S Friendswood Dr
Suite 200
Friendswood, TX 77546-3989

4800 N Scottsdale Rd
Suite 2500
Scottsdale, AZ 85251-7630

PO Box
Suite 890
Waco, TX 76703

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sondermind Provider Network LLC Clinical CurrentSince Jul 26, 2021 Accepting new patients
Heart of Texas Region MHMR Center CurrentSince Mar 1, 2019 Accepting new patients
Providence Health Alliance Past Accepting new patients

Locations

2021 Guadalupe St
Ste 260
Austin, TX 78705
Phone (202) 932-9958

1105 Jefferson Ave
Waco, TX 76701
Phone (254) 297-7000

110 S 12th St
Waco, TX 76701
Phone (254) 297-7124

Organizations & group practices 4

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": "1553731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1710448154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4825 ALLIANCE BLVD STE 150",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750935577",
            "telephone_number": "844-824-8775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4825 ALLIANCE BLVD STE 150",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750935577",
            "telephone_number": "844-824-8775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUFFSTATLER",
        "first_name": "ASHLY",
        "middle_name": "NICOLE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-28",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "62248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.