MEDICARE: MR. RICARDO ELIAS CONTRERAS M.A., LPC

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	76105	TX

General Provider Information

NPI Number	:	1326534579
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RICARDO ELIAS CONTRERAS M.A., LPC

Provider Business Mailing Address
First Line	:	2920 OAK PARK CIR STE 102
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76109-1853
Country	:	US
Telephone Number	:	956-292-1979
Fax Number	:

Provider Business Practice Location Address
First Line	:	2920 OAK PARK CIR STE 102
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76109-1853
Country	:	US
Telephone Number	:	956-292-1979
Fax Number	:

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

Provider Enumeration Date	:	07/10/2018
Last Update Date	:	10/30/2025

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