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General NPI Number Information
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NPI Number | 1053071548
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Entity Type | Organization
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Legal Business Name | NEW PATTERNS OF PERCEPTION LLC
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Dates
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Enumeration Date | 12/23/2021
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Last Update Date | 12/23/2021
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Provider Practice Location Address
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Address Line | 4217 ALTAMESA BLVD
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City | FORT WORTH
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State | TX
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Zip | 76133-5401
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Country | US
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Telephone | 972-430-1006
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Fax | 972-833-1006
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Provider Business Mailing Address
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Address Line | 4217 ALTAMESA BLVD
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City | FORT WORTH
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State | TX
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Zip | 76133-5401
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Country | US
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Telephone | 972-430-6706
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Fax | 972-833-1006
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Authorized Official
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Title or Position | MANAGER
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Name | KURT BILLUPS
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Credential | MA, LPC, LPHA
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Telephone | 972-430-6706
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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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 |
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License Number State |
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