Active NPI
Ciara L Weddborn, LPC INTERN
- Professional Counselor
- Fort Worth, TX
National Provider Identifier
1043642127
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 71054
- Practice address
- 111 NW 24TH St
Fort Worth, TX 76164-8544 - Phone
- (817) 626-6401
- Fax
- (817) 626-6400
- NPI assigned
- Jul 31, 2013
- Last updated
- Jul 31, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 71054 | TX | Primary |
Addresses
Primary practice location
111 NW 24TH St
Fort Worth, TX 76164-8544
Mailing address
111 NW 24TH St
Fort Worth, TX 76164-8544
Phone (817) 626-6401
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71054 | TX | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| RCW Neurotherapy & Wellness Clinic | Current | Accepting new patients | |
| PSP Professional Services, Inc. | Professional | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Mental Health Counselor
- Shenandoah, TX
- NPI 1053117812
-
- Professional Counselor
- Fort Worth, TX
- NPI 1922298322
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375228800000",
"number": "1043642127",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 NW 24TH ST",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761648544",
"telephone_number": "817-626-6401",
"fax_number": "817-626-6400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 NW 24TH ST",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761648544",
"telephone_number": "817-626-6401",
"fax_number": "817-626-6400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEDDBORN",
"first_name": "CIARA",
"middle_name": "L",
"name_prefix": "Mrs.",
"credential": "LPC INTERN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-07-31",
"last_updated": "2013-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "71054",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
- Kirstin Webster, FNP
- Melissa Webster, MS, CCC-SLP
- Joseph Dominic Wechsler Jr., PA-C
- Geoffrey W. Weckel, LPC
- Kati Nicole Weckman
- Wedgewood Nursing Home, L.P. (Wedgewood Nursing Home)
- Wedgewood SNF LLC (Wedgewood Nursing Home)
- Wedgwood Eyecare PC (Visualeyes)
- Hannah Elizabeth Weeks
- Natalie Lillian Weeks, PT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.