MEDICARE: BETH ANN CONTRERAS, MMFT, LMFT-S, LPC-S CHRISTIAN COUNSELING LLC

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	200869	TX

General Provider Information

NPI Number	:	1790199131
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BETH ANN CONTRERAS, MMFT, LMFT-S, LPC-S CHRISTIAN COUNSELING LLC

Provider Business Mailing Address
First Line	:	4913 RUFE SNOW DR
Second Line	:
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76180-7856
Country	:	US
Telephone Number	:	817-343-1379
Fax Number	:

Provider Business Practice Location Address
First Line	:	4913 RUFE SNOW DR
Second Line	:
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76180-7856
Country	:	US
Telephone Number	:	817-343-1379
Fax Number	:

Authorized Official
Title or Position	:	THERAPIST/OWNER
Name	:	ELIZABETH ANN CONTRERAS
Credential	:	LMFT-S, LPC-S
Telephone Number	:	915-329-0430

Provider Enumeration Date	:	06/13/2014
Last Update Date	:	06/13/2014

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