MEDICARE: EN ROUTE COUNSELING, 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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1962015362
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EN ROUTE COUNSELING, PLLC

Provider Business Mailing Address
First Line	:	3910 MALIBU SUN DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76137-6030
Country	:	US
Telephone Number	:	214-402-7301
Fax Number	:

Provider Business Practice Location Address
First Line	:	700 LONDONDERRY LN
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76205-7878
Country	:	US
Telephone Number	:	214-402-7301
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. CARYN WHITMORE
Credential	:	LPC
Telephone Number	:	214-402-7301

Provider Enumeration Date	:	08/25/2020
Last Update Date	:	08/25/2020

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