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General NPI Number Information
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NPI Number | 1003119769
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Entity Type | Individual
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Provider Name | MICHAEL DAVID WEBB LPC
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Gender | Male
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Dates
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Enumeration Date | 12/17/2010
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Last Update Date | 12/17/2010
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Provider Practice Location Address
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Address Line | 1858 KELLER PKWY SUITE D
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City | KELLER
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State | TX
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Zip | 76248-3757
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Country | US
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Telephone | 817-791-5703
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Fax |
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Provider Business Mailing Address
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Address Line | 4836 SANGERS CT
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City | FORT WORTH
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State | TX
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Zip | 76244-9119
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Country | US
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Telephone | 817-791-5703
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 9838
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 63885
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License Number State | TX
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