MEDICARE: KURT BILLUPS 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	106H00000X	Marriage & Family Therapist	64968	TX
2	101YM0800X	Mental Health Counselor	64968	TX
3	101YP2500X	Professional Counselor	64968	TX
4	101YA0400X	Addiction (Substance Use Disorder) Counselor	64698	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	:	1720564768
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KURT BILLUPS LPC

Provider Business Mailing Address
First Line	:	4217 ALTAMESA BLVD
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76133-5401
Country	:	US
Telephone Number	:	972-430-6706
Fax Number	:	972-833-1006

Provider Business Practice Location Address
First Line	:	4217 ALTAMESA BLVD
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76133-5401
Country	:	US
Telephone Number	:	972-430-6706
Fax Number	:	972-833-1006

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

Provider Enumeration Date	:	07/12/2018
Last Update Date	:	01/31/2026

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Directions to “ KURT BILLUPS LPC” Practice Location

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