Individual provider Active NPI

Mary Elouise Graves, LMFT

  • Marriage & Family Therapist
  • Fort Worth, TX
National Provider Identifier
1205941598
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
004748 Issued in TX
Practice address
2701 Burchill Rd N
Fort Worth, TX 76105-3012
Phone
(817) 534-0814
Fax
(817) 536-1556
NPI assigned
Aug 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 004748 TX Primary

Addresses

Primary practice location

2701 Burchill Rd N
Fort Worth, TX 76105-3012

Mailing address

2701 Burchill Rd N
Fort Worth, TX 76105-3012
Phone (817) 534-0814

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
004748TXMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Charities of Fort Worth, Inc Past Accepting new patients
Catholic Charities Diocese of Fort Worth Inc Past Accepting new patients

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": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205941598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 BURCHILL RD N",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761053012",
            "telephone_number": "817-534-0814",
            "fax_number": "817-536-1556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 BURCHILL RD N",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761053012",
            "telephone_number": "817-534-0814",
            "fax_number": "817-536-1556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVES",
        "first_name": "MARY",
        "middle_name": "ELOUISE",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "004748",
            "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 Jul 8, 2007; 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.