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General NPI Number Information
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NPI Number | 1215189907
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Entity Type | Organization
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Legal Business Name | TRI-S COUNSELING & EDUCATION
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Dates
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Enumeration Date | 10/14/2008
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Last Update Date | 10/14/2008
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Provider Practice Location Address
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Address Line | 4200 SOUTH FWY SUITE 424
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City | FORT WORTH
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State | TX
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Zip | 76115-1400
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Country | US
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Telephone | 817-920-9321
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Fax | 817-920-9336
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Provider Business Mailing Address
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Address Line | 4200 SOUTH FWY SUITE 424
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City | FORT WORTH
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State | TX
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Zip | 76115-1400
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Country | US
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Telephone | 817-920-9321
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Fax | 817-920-9336
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Authorized Official
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Title or Position | C.O.O
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Name | MRS. MERRILL L LITTLEBERRY
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Credential | LCSW, LCDC, CCM
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Telephone | 817-920-9321
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | 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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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