MEDICARE: JOEL JASSO LMFT-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	106H00000X	Marriage & Family Therapist	206125	TX

General Provider Information

NPI Number	:	1295614246
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOEL JASSO LMFT-A

Provider Business Mailing Address
First Line	:	10752 KITTERING TRL
Second Line	:
City	:	HASLET
State	:	TX
Zip	:	76052-6116
Country	:	US
Telephone Number	:	214-226-4277
Fax Number	:

Provider Business Practice Location Address
First Line	:	3418 N TARRANT PKWY STE 320
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76177-8646
Country	:	US
Telephone Number	:	817-653-9027
Fax Number	:

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

Provider Enumeration Date	:	09/02/2025
Last Update Date	:	09/02/2025

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