Organization Active NPI

Maternal Counseling Collaborative PLLC

  • Professional Counselor
  • Fort Worth, TX
National Provider Identifier
1093569899
Registry record updated Apr 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
MATERNAL COUNSELING COLLABORATIVE PLLC
Practice address
7235 Tall Tree Dr
Fort Worth, TX 76123-2540
Phone
(817) 753-8772
NPI assigned
Apr 16, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jennifer Eklund, LPCNPI 1013679125
Title
LPC, Owner
Phone
(316) 210-3893

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

7235 Tall Tree Dr
Fort Worth, TX 76123-2540

Mailing address

1617 Park Place Ave Ste 110
Fort Worth, TX 76110-1300

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1713225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713225600000",
    "number": "1093569899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1617 PARK PLACE AVE STE 110",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761101300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7235 TALL TREE DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761232540",
            "telephone_number": "817-753-8772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATERNAL COUNSELING COLLABORATIVE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-16",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A",
        "authorized_official_last_name": "EKLUND",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "LPC, OWNER",
        "authorized_official_telephone_number": "316-210-3893",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.