Healthcare Provider Details

I. General information

NPI: 1831806157
Provider Name (Legal Business Name): MYLAH M HAND LPC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/07/2022
Last Update Date: 05/16/2026
Certification Date: 05/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9133 ASKEW ST
FORT WORTH TX
76244-6040
US

IV. Provider business mailing address

520 E. VINE ST. PO BOX 369
FORT WORTH TX
76244
US

V. Phone/Fax

Practice location:
  • Phone: 254-315-4185
  • Fax:
Mailing address:
  • Phone: 254-315-4185
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701016162
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number83750
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: