Edna Chism Nicholas
NPI 1073933669ActiveIndividual· Social Worker, Clinical· Fort Worth, TX
Social Worker, Clinical in Fort Worth, Texas, licensed in TX, with an NPI issued in April 2014. Medicare paid $5,738 for services to 11 patients in 2024.
Overview
| NPI | 1073933669 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | Yes |
| NPI issued | Apr 22, 2014 |
| Last updated in NPPES | Nov 22, 2024 |
| Certified by provider | Nov 22, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | 55023 | TX |
| Counselor, Addiction (Substance Use Disorder) | 101YA0400X | 12258 | TX |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Social Worker (TX) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 11 |
|---|---|
| Services billed | 69 across 3 procedure codes |
| Paid by Medicare | $5,738 |
Education and affiliations
| Graduation year | 2003 |
|---|---|
| Medicare specialty | Clinical Social Worker |
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