Individual provider Active NPI

Mayra Yazmin Toledo, LCSW

  • Clinical Social Worker
  • Fort Worth, TX
National Provider Identifier
1962372615
Registry record updated Dec 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
109179 Issued in TX
Practice address
3200 Sanguinet St
Fort Worth, TX 76107-5355
Phone
(817) 255-2652
Fax
(817) 255-2657
NPI assigned
Nov 7, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 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 109179 TX Primary

Addresses

Primary practice location

3200 Sanguinet St
Fort Worth, TX 76107-5355

Mailing address

3200 Sanguinet St
Fort Worth, TX 76107-5355
Phone (817) 255-2652

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
I20260125000037 TX Practitioner - Clinical Social Worker 8729565353 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3200 Sanguinet St
Fort Worth, TX 76107-5355

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
109179TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lena Pope Home, Inc. Clinical CurrentSince Jan 15, 2026 Accepting new patients

Locations

3200 Sanguinet St
Fort Worth, TX 76107
Phone (817) 255-2500

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": "1762473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765929600000",
    "number": "1962372615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 SANGUINET ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761075355",
            "telephone_number": "817-255-2652",
            "fax_number": "817-255-2657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 SANGUINET ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761075355",
            "telephone_number": "817-255-2652",
            "fax_number": "817-255-2657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLEDO",
        "first_name": "MAYRA",
        "middle_name": "YAZMIN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-07",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "109179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.