Individual provider Active NPI

Paul Cherry, LPC, LCDC

  • Professional Counselor
  • Fort Worth, TX
National Provider Identifier
1164095196
Registry record updated Nov 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
86376 Issued in TX
Practice address
3509 Hulen St Ste 107
Fort Worth, TX 76107-6834
Phone
(817) 382-7130
NPI assigned
Jul 19, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 15834 TX
Professional Counselor 101YP2500X 86376 TX Primary

Addresses

Primary practice location

3509 Hulen St Ste 107
Fort Worth, TX 76107-6834

Mailing address

8708 Cloudyway Dr
Fort Worth, TX 76123-1688
Phone (717) 433-1234

Other practice location 1

8708 Cloudyway Dr
Fort Worth, TX 76123-1688
Phone (682) 245-1935

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

LicenseStateTypeSpecialty
15834TXMDAddiction (Substance Use Disorder) Counselor
86376TXMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1626652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762128000000",
    "number": "1164095196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8708 CLOUDYWAY DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761231688",
            "telephone_number": "717-433-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3509 HULEN ST STE 107",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761076834",
            "telephone_number": "817-382-7130"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8708 Cloudyway Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761231688",
            "country_code": "US",
            "telephone_number": "682-245-1935",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHERRY",
        "first_name": "PAUL",
        "credential": "LPC, LCDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-19",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "15834",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "86376",
            "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 Nov 3, 2025; 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.