MEDICARE: DR. STAUSSA C ERVIN EDD, LPC

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	101YM0800X	Mental Health Counselor	61666	TX

General Provider Information

NPI Number	:	1992031645
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STAUSSA C ERVIN EDD, LPC

Provider Business Mailing Address
First Line	:	250 W LANCASTER AVE APT 1506
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76102-6360
Country	:	US
Telephone Number	:	817-462-5057
Fax Number	:	817-462-5057

Provider Business Practice Location Address
First Line	:	250 W LANCASTER AVE APT 1506
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76102-6360
Country	:	US
Telephone Number	:	817-462-5057
Fax Number	:	817-462-5057

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/29/2009
Last Update Date	:	12/20/2021

Similar Medicare Providers

1427225705 — REDICLINIC US, LLC
Practice Location Address:

6360 LAKE WORTH BLVD
FORT WORTH, TX
76135-3604

Practice Phone: 866-607-7334
Practice Fax:

1518448315 — GIRLEAN CEOLA PARMES NURSE
Practice Location Address:

7037 WOODACRE RD
FORT WORTH, TX
76133-6360

Practice Phone: 817-915-7043
Practice Fax:

1861419012 — WAL-MART STORES TEXAS LLC
Practice Location Address:

6360 LAKE WORTH BLVD
LAKE WORTH, TX
76135-3604

Practice Phone: 817-237-1118
Practice Fax:

1700960366 — WAL-MART STORES TEXAS, LP
Practice Location Address:

6360 LAKE WORTH BLVD
LAKE WORTH, TX
76135-3604

Practice Phone: 817-237-0400
Practice Fax:

1902923741 — IDEAL EYECARE, P.A.
Practice Location Address:

6360 LAKE WORTH BLVD
LAKE WORTH, TX
76135-3604

Practice Phone: 817-238-7171
Practice Fax: 817-238-7172

1801050273 — NATIONAL HEARING CENTERS
Practice Location Address:

6360 LAKE WORTH BLVD
LAKE WORTH, TX
76135-3604

Practice Phone: 817-238-6799
Practice Fax: 817-238-6858

Directions to “ DR. STAUSSA C ERVIN EDD, LPC” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.