MEDICARE: TRESSA ELIZABETH MARR M.A. , LPC-A

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	97502	TX

General Provider Information

NPI Number	:	1740095603
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRESSA ELIZABETH MARR M.A. , LPC-A

Provider Business Mailing Address
First Line	:	PO BOX 12373
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76110-8373
Country	:	US
Telephone Number	:	682-219-8733
Fax Number	:

Provider Business Practice Location Address
First Line	:	16151 HIGHWAY 377 S
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76126-5544
Country	:	US
Telephone Number	:	682-219-8733
Fax Number	:

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

Provider Enumeration Date	:	02/10/2025
Last Update Date	:	02/10/2025

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