MEDICARE: FORT WORTH BRIEF THERAPY CENTER, PLLC

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	62762	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417295445
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FORT WORTH BRIEF THERAPY CENTER, PLLC

Provider Business Mailing Address
First Line	:	800 US HIGHWAY 287
Second Line	:	SUITE 1
City	:	RHOME
State	:	TX
Zip	:	76078-4323
Country	:	US
Telephone Number	:	817-301-6322
Fax Number	:	817-923-1490

Provider Business Practice Location Address
First Line	:	3113 S UNIVERSITY DR
Second Line	:	STE 201
City	:	FT WORTH
State	:	TX
Zip	:	76109-5616
Country	:	US
Telephone Number	:	817-923-1444
Fax Number	:	817-923-1490

Authorized Official
Title or Position	:	CO-OWNER
Name	:	MR. MATHEW A. TRAMMELL
Credential	:	LPC-S
Telephone Number	:	817-301-6322

Provider Enumeration Date	:	01/25/2013
Last Update Date	:	01/25/2013

Similar Medicare Providers

1790073930 — MS. ROBIN DICKEY LPC-INTERN
Practice Location Address:

3113 S UNIVERSITY DR , SUITE 201
FORT WORTH, TX
76109-5616

Practice Phone: 817-683-1457
Practice Fax:

1720085996 — JONATHAN DRU RIDDLE CRNA
Practice Location Address:

4916 OVERTON PLZ
FT WORTH, TX
76109-4415

Practice Phone: 817-734-7980
Practice Fax:

1487699898 — DR. MONETA B DE CASTRO MD
Practice Location Address:

4445 OAK PARK LANE , #201
FT WORTH, TX
76109

Practice Phone: 817-922-0798
Practice Fax: 817-922-0976

1891724852 — RANDALLS FOOD & DRUGS LP
Practice Location Address:

3000 S HULEN ST
FT WORTH, TX
76109-1929

Practice Phone: 817-570-2960
Practice Fax: 817-570-2965

1508885658 — STONEGATE NURSING CENTER LTD
Practice Location Address:

4201 STONEGATE BLVD
FT WORTH, TX
76109-9503

Practice Phone: 817-924-5440
Practice Fax: 817-924-5447

1821009820 — DR. JOHN B LOEFFELHOLZ DDS
Practice Location Address:

2800 S HULEN ST , SUITE 205
FT WORTH, TX
76109-1504

Practice Phone: 817-924-0506
Practice Fax: 817-924-0519

Directions to “FORT WORTH BRIEF THERAPY CENTER, PLLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.