MEDICARE: DELANEY ORTIZ LPC-A

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	91105	TX

General Provider Information

NPI Number	:	1003684481
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DELANEY ORTIZ LPC-A

Provider Business Mailing Address
First Line	:	1660 S UNIVERSITY DR # 1174
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76107-6524
Country	:	US
Telephone Number	:	469-665-9956
Fax Number	:

Provider Business Practice Location Address
First Line	:	1660 S UNIVERSITY DR # 1174
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76107-6524
Country	:	US
Telephone Number	:	469-665-9956
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2023
Last Update Date	:	10/03/2024

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Directions to “ DELANEY ORTIZ LPC-A” Practice Location

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