Individual provider Active NPI

Stephanie Lynn Fjetland, LCSW

  • Clinical Social Worker
  • Amarillo, TX
National Provider Identifier
1790590651
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
52595 Issued in TX
Practice address
PO Box 8994
Amarillo, TX 79114-8994
Phone
(737) 742-1256
NPI assigned
Feb 10, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2025

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 52595 TX Primary

Addresses

Primary practice location

PO Box 8994
Amarillo, TX 79114-8994

Mailing address

PO Box 8994
Amarillo, TX 79114-8994
Phone (737) 742-1256

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
I20260521004287 TX Practitioner - Clinical Social Worker 9436629284 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
52595TXMDClinical Social Worker

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": "1739145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1790590651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8994",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791148994",
            "telephone_number": "737-742-1256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 8994",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791148994",
            "telephone_number": "737-742-1256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FJETLAND",
        "first_name": "STEPHANIE",
        "middle_name": "LYNN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-10",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "52595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

Verify at the official NPI Registry.