Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Edna Chism Nicholas

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1073933669

Edna Chism Nicholas is a Clinical Social Worker in Fort Worth, Texas. Qualified in 2003, 23 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
23
Licensed in
TX
In the registry since
2014
Specialties on file
2
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Practice location Address checks out

3309 Winthrop Ave 90
Fort Worth, TX 76116-5614
Phone: (214) 886-4872
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 55023 (TX)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence 12258 (TX)

Record details

NPI number1073933669
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedApril 22, 2014
Last updated in NPPESNovember 22, 2024
Certification dateNovember 22, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2003 (23 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Fort Worth