NPIMap

Organization Active NPI

Lake Worth Counseling

  • Mental Health Counselor
  • Fort Worth, TX
National Provider Identifier
1194085506
Registry record updated Oct 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
17834 Issued in TX
Legal business name
LAKE WORTH COUNSELING
Practice address
4516 Boat Club Rd
Ste 106
Fort Worth, TX 76135-7019
Phone
(682) 556-9096
Fax
(817) 238-8333
NPI assigned
May 18, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2015

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

Authorized official

Name
Susan Schlosser, LPC
Title
Owner
Phone
(682) 556-9096

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 17834 TX Primary
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X 5110 TX

Addresses

Primary practice location

4516 Boat Club Rd
Ste 106
Fort Worth, TX 76135-7019

Mailing address

4516 Boat Club Rd
Ste 106
Fort Worth, TX 76135-7019
Phone (682) 556-9096

Other names 1

  • Susan Schlosser Former legal business name

National Provider Directory

National Provider Directory

Locations

4516 Boat Club Rd
Ste 106
Fort Worth, TX 76135
Phone (817) 238-0106

Practitioners & affiliated clinicians

Practitioners 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1337299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445904000000",
    "number": "1194085506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4516 BOAT CLUB RD",
            "address_2": "STE 106",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761357019",
            "telephone_number": "682-556-9096",
            "fax_number": "817-238-8333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4516 BOAT CLUB RD",
            "address_2": "STE 106",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761357019",
            "telephone_number": "682-556-9096",
            "fax_number": "817-238-8333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE WORTH COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-18",
        "last_updated": "2015-10-27",
        "status": "A",
        "authorized_official_last_name": "SCHLOSSER",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "682-556-9096",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "17834",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "5110",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Susan Schlosser",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Oct 27, 2015; 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.