Individual provider Active NPI

Cassidy Anne Hlavaty

  • Professional Counselor
  • Fort Worth, TX
National Provider Identifier
1730867383
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
85034 Issued in TX
Practice address
4800 Overton PLZ Ste 440
Fort Worth, TX 76109-4435
Phone
(903) 658-2705
NPI assigned
Jul 5, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 85034 TX Primary

Addresses

Primary practice location

4800 Overton PLZ Ste 440
Fort Worth, TX 76109-4435

Mailing address

4800 Overton PLZ Ste 440
Fort Worth, TX 76109-4435

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
I20241114003478 TX Practitioner - Mental Health Counselor 4587198486 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Senior Psychological Care Dallas I LLCGroup PAC ID 3375717044, 72 clinicians

Practice addresses (Care Compare)

4635 Southwest Fwy
Suite 635
Houston, TX 77027-7112
Phone 71385000491053

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
85034TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Senior Psychological Care Dallas I, LLC Professional CurrentSince Oct 28, 2024 Accepting new patients

Locations

1900 Oneal St
Gainesville, TX 76240
Phone (940) 665-2826

4635 Southwest Fwy
Ste 635
Houston, TX 77027
Phone (214) 923-7777

434 Paza Dr
Mesquite, TX 75149
Phone (972) 286-6489

7146 Baker Blvd
Richland Hills, TX 76118
Phone (817) 589-1734

Organizations & group practices 1

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": "1688515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1730867383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 OVERTON PLZ STE 440",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761094435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 OVERTON PLZ STE 440",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761094435",
            "telephone_number": "903-658-2705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HLAVATY",
        "first_name": "CASSIDY",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-05",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "85034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.