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INGRID L SHADOW LCSW
NPI 1063272292
Social Worker - Clinical in Fort Worth, TX

Active since March 22, 2024PECOS EnrolledAccepts Medicare Assignment
3540 MANDERLY PL, FORT WORTH, TX 76109(817) 739-8170 Get Directions Write a Review

NPPES record last updated: March 22, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Ingrid L Shadow Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

INGRID L SHADOW LCSW (NPI 1063272292) is an individual clinical provider in Fort Worth, Texas, licensed in Texas (35298) and active in the NPI registry since March 2024. She is enrolled in Medicare PECOS, maintains a secondary practice location in Cleburne, and is a graduate of Other (1999).

NPPES Registry Identity

NPI1063272292
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameINGRID L SHADOWCredential: LCSW
Location Address3540 MANDERLY PLFort Worth, TX 76109-4520
Mailing Address3540 Manderly PlFort Worth, TX 76109-4520 · (817) 739-8170
Phone(817) 739-8170
Sole ProprietorYes
Medical School CMSOtherGraduated 1999
Enumeration DateMarch 22, 2024
NPPES CertifiedMarch 22, 2024
✔ NPI 1063272292 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in TX · 35298
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
3540 MANDERLY PL, Fort Worth, TX 76109
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Secondary Practice Location 1

Location 11607 N Main St Ste ACleburne, TX 76033-3875 · Phone (817) 739-8170

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, Oscar Insurance Company, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ingrid L Shadow Lcsw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID749710861
PECOS Enrollment IDI20250205000174
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Ingrid Shadow reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Total Life Inc.
1,110 mi
Group Psychotherapy
110 FRONT ST STE 300
Jupiter, FL 33477
  • Reassigned Medicare billing, Texas enrollment
  • 31 clinicians in this Medicare group
NPI 1053909267 (800) 567-5433
Total Life Fl PA
1,209 mi
Integrative Medicine
10811 BARN WOOD LN
Potomac, MD 20854
  • Reassigned Medicare billing, Texas enrollment
  • 22 clinicians in this Medicare group
NPI 1447057286 (800) 567-5433

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 76109 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $56.47 – $171.07
Typical copayment $0.00 (range $14.11 – $42.76)
Most-billed visit code NA
Established Patient
$70.45 typical visit price
range $18.18 – $139.68
Typical copayment $17.61 (range $4.54 – $34.92)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BURTON ALEXANDER SHADOW
Social Worker (Clinical)
3540 MANDERLY PL
FORT WORTH, TX 76109
Tarrant County (817) 739-8174

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ingrid Shadow's NPI number?

The NPI number for Ingrid Shadow is 1063272292. It was assigned to this individual provider in the NPPES registry on March 22, 2024.

Where is Ingrid Shadow located?

Ingrid Shadow practices at 3540 Manderly Pl, Fort Worth, TX 76109. The listed phone number is (817) 739-8170.

What is Ingrid Shadow's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Ingrid Shadow enrolled in Medicare?

Yes. Ingrid Shadow is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Ingrid Shadow's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ingrid Shadow reassigns Medicare benefits to 2 organizations: Total Life Inc. (Jupiter, FL) and Total Life Fl PA (Potomac, MD). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Ingrid Shadow's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Ingrid Shadow accept?

Health plans from Blue Cross and Blue Shield of Texas, Oscar Insurance Company and UnitedHealthcare list Ingrid Shadow as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Ingrid Shadow was last updated on March 22, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.