Organization Active NPI

Paul L Warren, PSYD, PC

  • Adult Mental Health Clinic/Center
  • Fort Worth, TX
National Provider Identifier
1114487329
Registry record updated Mar 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
PAUL L WARREN, PSYD, PC
Practice address
5658 Westcreek Dr Ste 400
Fort Worth, TX 76133-2254
Phone
(817) 292-4179
Fax
(817) 918-4839
NPI assigned
Mar 22, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2019

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

Authorized official

Name
Dr. Paul Lawrence Warren, PSYD
Title
Clinical Psychologist
Phone
(817) 292-4179

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

5658 Westcreek Dr Ste 400
Fort Worth, TX 76133-2254

Mailing address

PO Box 331584
Fort Worth, TX 76163-1584
Phone (817) 292-4179

Other identifiers 1

IdentifierTypeStateIssuer
PT000U23XMedicaidTX

National Provider Directory

National Provider Directory

Locations

5658 Westcreek Dr
Ste 400
Fort Worth, TX 76133
Phone (817) 292-4179

Practitioners & affiliated clinicians

Practitioners 2

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": "1553212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553212800000",
    "number": "1114487329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 331584",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761631584",
            "telephone_number": "817-292-4179",
            "fax_number": "817-918-4839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5658 WESTCREEK DR STE 400",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761332254",
            "telephone_number": "817-292-4179",
            "fax_number": "817-918-4839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL L WARREN, PSYD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-22",
        "last_updated": "2019-03-22",
        "status": "A",
        "authorized_official_last_name": "WARREN",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "LAWRENCE",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "817-292-4179",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PT000U23X",
            "state": "TX"
        }
    ],
    "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 Mar 22, 2019; 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.