Individual provider Active NPI

Bruce Feltrup-Exum, M.DIV, LMFT

  • Marriage & Family Therapist
  • Fort Worth, TX
National Provider Identifier
1144373192
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
201097 Issued in TX
Practice address
6551 Harris Pkwy Ste 240
Fort Worth, TX 76132-6103
Phone
(817) 735-4165
Fax
(817) 735-4688
NPI assigned
Jan 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 201097 TX Primary

Addresses

Primary practice location

6551 Harris Pkwy Ste 240
Fort Worth, TX 76132-6103

Mailing address

6551 Harris Pkwy Ste 240
Fort Worth, TX 76132-6103
Phone (817) 735-4165

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231229002003 TX Practitioner - Marriage and Family Therapist 0941650196 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fair Winds Assessment and Counseling Center PLLCGroup PAC ID 9032569280, 3 clinicians

Practice addresses (Care Compare)

6551 Harris Pkwy
Suite 240
Fort Worth, TX 76132-6103
Phone (817) 735-4165

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fair Winds Assessment and Counseling Center PLLC Marriage & Family Therapist CurrentSince Jan 1, 2024 Accepting new patients
Heather D Perez LPC PLLC PastSince Jan 1, 2024 Accepting new patients

Locations

6551 Harris Pkwy
Ste 240
Fort Worth, TX 76132
Phone (817) 735-4165

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1144373192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6551 HARRIS PKWY STE 240",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761326103",
            "telephone_number": "817-735-4165",
            "fax_number": "817-735-4688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6551 HARRIS PKWY STE 240",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761326103",
            "telephone_number": "817-735-4165",
            "fax_number": "817-735-4688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELTRUP-EXUM",
        "first_name": "BRUCE",
        "name_prefix": "Mr.",
        "credential": "M.DIV, LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-20",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "201097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.