Active NPI
Heather Renee Yeubanks, LCSW
- Clinical Social Worker
- Fort Worth, TX
National Provider Identifier
1902532245
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 54694
- Practice address
- 900 Matisse Dr Apt 2055
Fort Worth, TX 76107-2490 - Phone
- (214) 335-5922
- NPI assigned
- Jul 28, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 | 54694 | TX | Primary |
Addresses
Primary practice location
900 Matisse Dr Apt 2055
Fort Worth, TX 76107-2490
Mailing address
900 Matisse Dr Apt 2055
Fort Worth, TX 76107-2490
Phone (214) 335-5922
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 54694 | TX | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Teladoc Health Medical Group, P.a. | Clinical | Current | Accepting new patients |
Interoperability endpoints
- heatheryeubanks@tdh.allscriptsdirect.net
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1658966400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658966400000",
"number": "1902532245",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 MATISSE DR APT 2055",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761072490",
"telephone_number": "214-335-5922"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 MATISSE DR APT 2055",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761072490",
"telephone_number": "214-335-5922"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YEUBANKS",
"first_name": "HEATHER",
"middle_name": "RENEE",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-07-28",
"last_updated": "2022-07-28",
"certification_date": "2022-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "54694",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.