Adrienne Marie Shabazz, LBSW

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

License

25692 Issued in TX

Practice address

10129 S Race St
Ft Worth, TX 76140-9417

Phone

(817) 789-0116

NPI assigned

Jan 19, 2008

Last updated

Apr 21, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• N/a N/a N/a Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Children & Family Services

  dba Adrienne M. Johnson

  • Case Manager/Care Coordinator
  • Fort Worth, TX
  • NPI 1669030367
  NPD

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

{
    "created_epoch": "1200700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682035200000",
    "number": "1881870921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8212",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761240212",
            "telephone_number": "817-789-0116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10129 S RACE ST",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761409417",
            "telephone_number": "817-789-0116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHABAZZ",
        "first_name": "ADRIENNE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LBSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-19",
        "last_updated": "2023-04-21",
        "certification_date": "2023-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "TX",
            "license": "25692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171M00000X",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "N/A",
            "last_name": "N/A",
            "middle_name": "N/A",
            "credential": "N/A",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Ashley E Shabareck, NP
• Shabnam Qasim Mdpa
• Nabeel M Shabout, M.D.
• Janet Shackelford, MD
• Jael Shackleford, LPC ASSOCIATE
• Edward Charles Shadiack III, D.O.

• Case Manager/Care Coordinator in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Case Manager/Care Coordinator in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.