MEDICARE: MR. MICHAEL DOUGLAS HERNDON MAMFC LPC

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	101Y00000X	Counselor	18550	TX
2	101YP2500X	Professional Counselor	18550	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	277782	OTHER	TX	AMERIGROUP

General Provider Information

NPI Number	:	1588758619
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MICHAEL DOUGLAS HERNDON MAMFC LPC

Provider Business Mailing Address
First Line	:	1424 SUMMIT AVE
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76102-5912
Country	:	US
Telephone Number	:	817-335-4041
Fax Number	:	817-332-3203

Provider Business Practice Location Address
First Line	:	1424 SUMMIT AVE
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76102-5912
Country	:	US
Telephone Number	:	817-335-4041
Fax Number	:	817-332-3203

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	09/11/2025

Similar Medicare Providers

1225177512 — MS. CARLA YVONNE STOREY LCSW
Practice Location Address:

1424 SUMMIT AVE
FORT WORTH, TX
76102-5912

Practice Phone: 817-335-4673
Practice Fax:

1356480693 — ELIZABETH ANGELINA REYES LCSW
Practice Location Address:

1424 SUMMIT AVE
FORT WORTH, TX
76102-5912

Practice Phone: 817-335-4041
Practice Fax: 817-335-4043

1285751867 — MR. VALERIE VALENTINE-HEATH
Practice Location Address:

1424 SUMMIT AVE
FORT WORTH, TX
76102-5912

Practice Phone: 817-335-4041
Practice Fax:

1487688594 — PATRICK A CONWAY DO
Practice Location Address:

7001 GRANBURY RD
FORT WORTH, TX
76133-5912

Practice Phone: 817-346-1925
Practice Fax: 817-292-7237

1225063019 — ALFRED T HULSE DO
Practice Location Address:

7001 GRANBURY RD
FORT WORTH, TX
76133-5912

Practice Phone: 817-346-1925
Practice Fax: 817-292-7237

1184643744 — PAMELA S WHITENER NP
Practice Location Address:

7001 GRANBURY RD
FORT WORTH, TX
76133-5912

Practice Phone: 817-346-1925
Practice Fax: 817-292-7237

Directions to “ MR. MICHAEL DOUGLAS HERNDON MAMFC LPC” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.