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NPI Code Detail

MEDICARE: CATHOLIC CHARITIES OF FORT WORTH, INC

MEDICARE: CATHOLIC CHARITIES OF FORT WORTH, INC
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
1101YP2500XProfessional Counselor

General Provider Information

NPI Number : 1962445791
Entity Type Code : Organization
Provider Name (Legal Business Name) : CATHOLIC CHARITIES OF FORT WORTH, INC
Provider Business Mailing Address
First Line : 2701 BURCHILL RD N
Second Line :
City : FORT WORTH
State : TX
Zip : 76105-3012
Country : US
Telephone Number : 817-534-0814
Fax Number : 817-536-1556
Provider Business Practice Location Address
First Line : 2701 BURCHILL RD N
Second Line :
City : FORT WORTH
State : TX
Zip : 76105-3012
Country : US
Telephone Number : 817-534-0814
Fax Number : 817-536-1556
Authorized Official
Title or Position : VICE PRESIDENT - ADMINISTRATION
Name : MS. MONICA QUIROZ
Credential :
Telephone Number : 817-534-0814
Provider Enumeration Date : 06/13/2006
Last Update Date : 08/22/2020

Similar Medicare Providers

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Practice Location Address:
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1679680094 — MR. RUSSELL MARTIN DEAN LPC
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1104938968 — MRS. MERRY LOUISE FLOYD LCSW
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1386807204 — CATHOLIC CHARITIES DIOCESE OF FORT WORTH INC
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1578799649 — JENNIFER LEE SHEFFIELD R.N.
Practice Location Address:
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FORT WORTH, TX
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1447482641 — CHARLES HENRY LAVINE LPC-S
Practice Location Address:
2701 BURCHILL RD N
FORT WORTH, TX
76105-3012
Practice Phone: 817-534-0814
Practice Fax: 817-536-1556

Directions to “CATHOLIC CHARITIES OF FORT WORTH, INC ” Practice Location

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