Healthcare Provider Details

I. General information

NPI: 1558259465
Provider Name (Legal Business Name): COVENANT COUNSELING AND CONSULTING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2025
Last Update Date: 08/11/2025
Certification Date: 08/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 CAMPUS DR
FORT WORTH TX
76119-5535
US

IV. Provider business mailing address

4933 CEDAR BRUSH DR
FORT WORTH TX
76123-2958
US

V. Phone/Fax

Practice location:
  • Phone: 682-321-0764
  • Fax:
Mailing address:
  • Phone: 682-325-9579
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: JOHN WHITFIELD III
Title or Position: CEO/COUNCILOR
Credential: M.A.
Phone: 682-325-9579