MEDICARE: OPPORTUNITIES COUNSELING CTR, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	32064	TX

General Provider Information

NPI Number	:	1184842452
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPPORTUNITIES COUNSELING CTR, INC.

Provider Business Mailing Address
First Line	:	601 UNIVERSITY DR. STE 105
Second Line	:
City	:	FT. WORTH
State	:	TX
Zip	:	76107-2168
Country	:	US
Telephone Number	:	817-360-2983
Fax Number	:	817-386-5880

Provider Business Practice Location Address
First Line	:	601 UNIVERSITY DR. STE 105
Second Line	:
City	:	FT. WORTH
State	:	TX
Zip	:	76107-2168
Country	:	US
Telephone Number	:	817-360-2983
Fax Number	:	817-386-5880

Authorized Official
Title or Position	:	OWNER
Name	:	ENRIQUE SALDIVAR
Credential	:	LCSW
Telephone Number	:	817-360-2983

Provider Enumeration Date	:	04/23/2007
Last Update Date	:	08/01/2008

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