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NPI Code Detail

MEDICARE: MRS. PATRICIA CORREA LPC-S

MEDICARE: MRS. PATRICIA CORREA 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
1101YM0800XMental Health CounselorMH8929FL
2101YP2500XProfessional Counselor63296TX

General Provider Information

NPI Number : 1649324815
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. PATRICIA CORREA LPC-S
Provider Business Mailing Address
First Line : 8107 LATIGO DR
Second Line :
City : ARLINGTON
State : TX
Zip : 76001-7241
Country : US
Telephone Number : 915-820-7341
Fax Number :
Provider Business Practice Location Address
First Line : 3712 WICHITA ST
Second Line :
City : FORT WORTH
State : TX
Zip : 76119-2866
Country : US
Telephone Number : 915-820-7341
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2007
Last Update Date : 03/17/2018

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Directions to “ MRS. PATRICIA CORREA LPC-S” Practice Location

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