NPI 1811524085 · live from the CMS NPI Registry
22kill
Counselor, Mental Health in Fort Worth, TX. National Provider Identifier 1811524085, active.
NPI record
| NPI | 1811524085 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Counselor, Mental Health 101YM0800X |
| Practice location | 855 Texas St Ste 105, Fort Worth, TX 76102 |
| Practice phone | 682-990-6242 |
| Mailing address | 855 Texas St, Fort Worth, TX 76102 |
| Enumerated | March 26, 2020 |
| Last updated | March 26, 2020 |
| Authorized official | Tempa Sherrill, Coo |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatry & Neurology, Psychiatry | 2084P0800X | — |
| Counselor, Mental Health primary | 101YM0800X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.