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General NPI Number Information
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NPI Number | 1447128491
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Entity Type | Individual
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Provider Name | MARC WEST LPC ASSOCIATE
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Gender | Male
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Dates
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Enumeration Date | 10/29/2025
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Last Update Date | 10/29/2025
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Provider Practice Location Address
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Address Line | 451 UNIVERSITY DR STE 201
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City | FORT WORTH
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State | TX
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Zip | 76107-2130
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Country | US
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Telephone | 817-304-7549
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Fax |
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Provider Business Mailing Address
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Address Line | 1105 TRACE RD
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City | CLEBURNE
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State | TX
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Zip | 76033-6124
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Country | US
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Telephone | 817-760-0819
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 96579
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License Number State | TX
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