Healthcare Provider Details

I. General information

NPI: 1215559422
Provider Name (Legal Business Name): CMAC COUNSELING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2020
Last Update Date: 09/27/2024
Certification Date: 09/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 COLLIER ST STE 225
FORT WORTH TX
76102-3584
US

IV. Provider business mailing address

910 COLLIER ST STE 225
FORT WORTH TX
76102-3584
US

V. Phone/Fax

Practice location:
  • Phone: 817-602-2143
  • Fax:
Mailing address:
  • Phone: 817-602-2143
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: CHRISTI LORRAINE MCDONALD
Title or Position: LICENSED PROFESSIONAL COUNSELOR
Credential: LPC
Phone: 817-602-2143