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General NPI Number Information
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NPI Number | 1881644664
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Entity Type | Individual
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Provider Name | ROBERT JOSEPH PITRE SR. LMSW-ACP
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Gender | Male
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 07/25/2019
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Provider Practice Location Address
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Address Line | 6410 SOUTHWEST BLVD STE 230
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City | BENBROOK
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State | TX
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Zip | 76109-6920
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Country | US
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Telephone | 817-335-5489
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Fax | 817-335-7242
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Provider Business Mailing Address
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Address Line | 4300 CUMBERLAND RD N
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City | FORT WORTH
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State | TX
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Zip | 76116-8106
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Country | US
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Telephone | 817-703-3210
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Fax | 817-335-7242
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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 | 1063
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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 | S17899
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License Number State | TX
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