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General NPI Number Information
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NPI Number | 1932073574
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Entity Type | Organization
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Legal Business Name | ROSE LAVILLA COUNSELING, PLLC
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Dates
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Enumeration Date | 10/04/2025
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Last Update Date | 10/04/2025
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Provider Practice Location Address
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Address Line | 4200 BRIDGEVIEW DR
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City | FORT WORTH
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State | TX
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Zip | 76109-5560
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Country | US
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Telephone | 682-384-4588
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Fax |
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Provider Business Mailing Address
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Address Line | 4200 BRIDGEVIEW DR APT 1537
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City | FORT WORTH
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State | TX
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Zip | 76109-5576
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | ROSEMARIE LAVILLA
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Credential | LCSW
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Telephone | 817-807-7963
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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