Active NPI
Mona Marbeth Fogt, LCSW ACP
- Clinical Social Worker
- Houston, TX
National Provider Identifier
1891865804
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 01443
- Practice address
- 1313 Campbell Rd
BLDG C
Houston, TX 77055 - Phone
- (713) 973-8245
- Fax
- (713) 973-0545
- NPI assigned
- Nov 8, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 01443 | TX | Primary |
Addresses
Primary practice location
1313 Campbell Rd
BLDG C
Houston, TX 77055
Mailing address
1313 Campbell Rd
BLDG C
Houston, TX 77055
Phone (713) 973-8245
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1391007321316 | Other | TX | AIS |
| WS0004452 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01443 | TX | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1891865804",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1313 CAMPBELL RD",
"address_2": "BLDG C",
"city": "HOUSTON",
"state": "TX",
"postal_code": "77055",
"telephone_number": "713-973-8245",
"fax_number": "713-973-0545"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1313 CAMPBELL RD",
"address_2": "BLDG C",
"city": "HOUSTON",
"state": "TX",
"postal_code": "77055",
"telephone_number": "713-973-8245",
"fax_number": "713-973-0545"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOGT",
"first_name": "MONA",
"middle_name": "MARBETH",
"name_prefix": "Mrs.",
"credential": "LCSW ACP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "01443",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AIS",
"identifier": "1391007321316",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "WS0004452",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.