MEDICARE: ADRIANA VELAZQUEZ SANDERS LPC-S

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	72540	TX

General Provider Information

NPI Number	:	1598489668
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADRIANA VELAZQUEZ SANDERS LPC-S

Provider Business Mailing Address
First Line	:	4500 MERCANTILE PLAZA SR.
Second Line	:	#300
City	:	FORT WORTH
State	:	TX
Zip	:	76137
Country	:	US
Telephone Number	:	817-803-9985
Fax Number	:

Provider Business Practice Location Address
First Line	:	4500 MERCANTILE PLAZA SR.
Second Line	:	#300
City	:	FORT WORTH
State	:	TX
Zip	:	76137
Country	:	US
Telephone Number	:	817-803-9985
Fax Number	:

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

Provider Enumeration Date	:	10/03/2022
Last Update Date	:	01/12/2026

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