Healthcare Provider Details

I. General information

NPI: 1467188094
Provider Name (Legal Business Name): ELIZABETH ZAPATA LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2022
Last Update Date: 12/21/2023
Certification Date: 12/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3840 HULEN ST
FORT WORTH TX
76107-7277
US

IV. Provider business mailing address

PO BOX 2603
FORT WORTH TX
76113-2603
US

V. Phone/Fax

Practice location:
  • Phone: 817-569-4300
  • Fax:
Mailing address:
  • Phone: 817-569-4300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number107662
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: