Professional Counseling Center PLLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

63253 Issued in TX

Legal business name

PROFESSIONAL COUNSELING CENTER PLLC

Practice address

6612 N Riverside Dr
Suite 140
Fort Worth, TX 76137-6663

Phone

(817) 306-9770

Fax

(817) 306-0664

NPI assigned

Mar 3, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Yvette Phillips, PSYDNPI 1265479562

Title

Clinical Director

Phone

(817) 306-9770

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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

• Yvette Michelle Phillips, PSY.D.

  • Professional Counselor
  • Fort Worth, TX
  • NPI 1265479562
  NPD (past) Authorized official
• Lydia Ann Ivory, LPCI

  • Professional Counselor
  • Fort Worth, TX
  • NPI 1881914380
  NPD (past)

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

{
    "created_epoch": "1204502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213920000000",
    "number": "1245400589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6612 N RIVERSIDE DR",
            "address_2": "SUITE 140",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761376663",
            "telephone_number": "817-306-9770",
            "fax_number": "817-306-0664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6612 N RIVERSIDE DR",
            "address_2": "SUITE 140",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761376663",
            "telephone_number": "817-306-9770",
            "fax_number": "817-306-0664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL COUNSELING CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-03",
        "last_updated": "2008-06-20",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "YVETTE",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "817-306-9770",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "63253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1883613-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Procare Pharmacy LLC (CVS Pharmacy #02751)
• Procare Pharmacy, LLC (CVS Pharmacy #02751)
• Professional Caretakers Inc.
• Professional Clinical Laboratory Inc (ProLab)
• Professional Clinical Laboratory, Inc (ProLab)
• Professional Ehc Eastchase LLC
• Progressive Home Care Fort Worth Inc.
• Progressive Pathways Psychiatry PLLC
• Progressive Psychiatry, P.a. (Mindful)
• Teresa Proietti, DO

• Mental Health Counselor in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Mental Health Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2008; 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.