MEDICARE: PSP PROFESSIONAL SERVICES, 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	101YP2500X	Professional Counselor	59574	TX
2	101YP2500X	Professional Counselor	19007	TX

General Provider Information

NPI Number	:	1922298322
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PSP PROFESSIONAL SERVICES, INC.

Provider Business Mailing Address
First Line	:	PO BOX 4772
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76164
Country	:	US
Telephone Number	:	817-626-6401
Fax Number	:	844-360-9227

Provider Business Practice Location Address
First Line	:	2831 ELLIS AVE
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76106
Country	:	US
Telephone Number	:	817-626-6401
Fax Number	:	844-360-9227

Authorized Official
Title or Position	:	BUUSINESS OWNER/PRESIDENT
Name	:	GABRIELA GARCIA
Credential	:	LPC-S. PSYD
Telephone Number	:	817-626-6401

Provider Enumeration Date	:	07/31/2007
Last Update Date	:	04/16/2026

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Directions to “PSP PROFESSIONAL SERVICES, INC. ” Practice Location

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