Individual provider Active NPI

Cathleen Lynn Weidner, MSW

  • Clinical Social Worker
  • Fort Worth, TX
National Provider Identifier
1962684472
Registry record updated May 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
14739 Issued in TX
Practice address
6073 The Resort Blvd
Fort Worth, TX 76179-6632
Phone
(214) 707-4148
NPI assigned
Nov 27, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2022

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 14739 TX Primary

Addresses

Primary practice location

6073 The Resort Blvd
Fort Worth, TX 76179-6632

Mailing address

6073 The Resort Blvd
Fort Worth, TX 76179-6632
Phone (214) 707-4148

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

LicenseStateTypeSpecialty
14739TXMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1196121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653955200000",
    "number": "1962684472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6073 THE RESORT BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761796632",
            "telephone_number": "214-707-4148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6073 THE RESORT BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761796632",
            "telephone_number": "214-707-4148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIDNER",
        "first_name": "CATHLEEN",
        "middle_name": "LYNN",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-27",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "14739",
            "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 May 31, 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.

Verify at the official NPI Registry.