Individual provider Active NPI

Brittany Victoria Klabunde, LCSW

  • Clinical Social Worker
  • Denton, TX
National Provider Identifier
1942970298
Registry record updated Sep 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
58132 Issued in TX
Practice address
1121 Dallas Dr Ste 6
Denton, TX 76205-5100
Phone
(940) 483-1789
NPI assigned
Sep 17, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 58132 TX Primary

Addresses

Primary practice location

1121 Dallas Dr Ste 6
Denton, TX 76205-5100

Mailing address

1121 Dallas Dr Ste 6
Denton, TX 76205-5100
Phone (940) 483-1789

Other names 1

  • Mrs. Brittany Victoria Klabunde Professional name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address brittany@olivebranchfamilytherapy.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Feb 12, 2024 through Feb 12, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
58132TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Olive Branch Family Therapy Inc. PastSince Sep 23, 2021 Accepting new patients

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": "1631836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631836800000",
    "number": "1942970298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 DALLAS DR STE 6",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762055100",
            "telephone_number": "940-483-1789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 DALLAS DR STE 6",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762055100",
            "telephone_number": "940-483-1789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLABUNDE",
        "first_name": "BRITTANY",
        "middle_name": "VICTORIA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-17",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "58132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "brittany@olivebranchfamilytherapy.com",
            "affiliation": "N",
            "endpointDescription": "Secure Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1121 Dallas Dr Ste 6",
            "city": "Denton",
            "state": "TX",
            "country_code": "US",
            "postal_code": "762055100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "BRITTANY",
            "last_name": "KLABUNDE",
            "middle_name": "VICTORIA",
            "prefix": "MRS.",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Denton, TX

Sources for this page

Verify at the official NPI Registry.