Healthcare Provider Details

I. General information

NPI: 1851883961
Provider Name (Legal Business Name): HEATHER D PEREZ LPC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2018
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6777 CAMP BOWIE BLVD STE 229
FORT WORTH TX
76116-7157
US

IV. Provider business mailing address

6777 CAMP BOWIE BLVD STE 229
FORT WORTH TX
76116-7157
US

V. Phone/Fax

Practice location:
  • Phone: 682-703-1311
  • Fax: 817-735-4688
Mailing address:
  • Phone: 682-703-1311
  • Fax: 817-735-4688

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number71867
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: HEATHER DAWN PEREZ TROWBRIDGE
Title or Position: OWNER
Credential: LPC
Phone: 682-231-1456