MEDICARE: DISTINCT 1 THERAPY, PLLC

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

General Provider Information

NPI Number	:	1861341067
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DISTINCT 1 THERAPY, PLLC

Provider Business Mailing Address
First Line	:	3418 N TARRANT PKWY STE 320
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76177-8646
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3418 N TARRANT PKWY STE 320
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76177-8646
Country	:	US
Telephone Number	:	817-653-9027
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER
Name	:	MISTY MICHELLE JASSO
Credential	:
Telephone Number	:	214-226-4326

Provider Enumeration Date	:	01/22/2026
Last Update Date	:	01/22/2026

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