MEDICARE: PERCEPT 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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1871165829
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PERCEPT COUNSELING, LLC

Provider Business Mailing Address
First Line	:	1451 ROCKHILL CT
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76112-2932
Country	:	US
Telephone Number	:	682-233-1681
Fax Number	:

Provider Business Practice Location Address
First Line	:	1451 ROCKHILL CT
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76112-2932
Country	:	US
Telephone Number	:	682-233-1681
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	BRAD LYNN RZEPNIEWSKI
Credential	:	LCSW
Telephone Number	:	682-233-1681

Provider Enumeration Date	:	07/10/2021
Last Update Date	:	07/10/2021

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