NPIMap

Organization Active NPI

Fair Winds Assessment and Counseling Center PLLC

  • Marriage & Family Therapist
  • Fort Worth, TX
National Provider Identifier
1225544877
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
FAIR WINDS ASSESSMENT AND COUNSELING CENTER PLLC
Practice address
6551 Harris Pkwy Ste 240
Fort Worth, TX 76132-6103
Phone
(817) 735-4165
Fax
(817) 735-4688
NPI assigned
Dec 19, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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

Authorized official

Name
Bruce Feltrup-Exum, M.DIV., LMFTNPI 1144373192
Title
Provider
Phone
(817) 735-4165

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 106H00000X 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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231229001675 TX Part B Supplier - Clinic/Group Practice 9032569280 Receives reassigned benefits from 3 practitioners
Practice locations: Fort Worth, TX

National Provider Directory

National Provider Directory

Locations

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

6100 Western Pl
Ste 408
Fort Worth, TX 76107
Phone (469) 223-2427

Practitioners & affiliated clinicians

Practitioners 7

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": "1513641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707177600000",
    "number": "1225544877",
    "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": "817-735-4165"
        },
        {
            "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": {
        "organization_name": "FAIR WINDS ASSESSMENT AND COUNSELING CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-19",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A",
        "authorized_official_last_name": "FELTRUP-EXUM",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "817-735-4165",
        "authorized_official_credential": "M.DIV., LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "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 Feb 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.