Active NPI
Alex Guevara III, LPC
- Counselor
- Fort Worth, TX
National Provider Identifier
1255986832
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 75016
- Practice address
- 1217 Grand Ave
Fort Worth, TX 76164-9041 - Phone
- (817) 618-0513
- Fax
- (817) 549-0095
- NPI assigned
- Aug 9, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 75016 | TX | Primary |
Addresses
Primary practice location
1217 Grand Ave
Fort Worth, TX 76164-9041
Mailing address
1217 Grand Ave
Fort Worth, TX 76164-9041
Phone (817) 618-0513
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 348806 | Other | TX | LPC CONTROL NUMBER |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 75016 | TX | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1633392000000",
"number": "1255986832",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1217 GRAND AVE",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761649041",
"telephone_number": "817-618-0513",
"fax_number": "817-549-0095"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1217 GRAND AVE",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761649041",
"telephone_number": "817-618-0513",
"fax_number": "817-549-0095"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUEVARA",
"first_name": "ALEX",
"name_prefix": "Mr.",
"name_suffix": "III",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-08-09",
"last_updated": "2021-10-05",
"certification_date": "2021-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor",
"state": "TX",
"license": "75016",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LPC CONTROL NUMBER",
"identifier": "348806",
"state": "TX"
}
],
"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 Oct 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.