Individual provider Active NPI

Courtney P Leazer, LCDC, LPC

  • Professional Counselor
  • Fort Worth, TX
National Provider Identifier
1316575475
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
83074 Issued in TX
Practice address
3840 Hulen St
Fort Worth, TX 76107-7277
Phone
(817) 335-3022
NPI assigned
Apr 1, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 83074 TX Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 15197 TX

Addresses

Primary practice location

3840 Hulen St
Fort Worth, TX 76107-7277

Mailing address

3840 Hulen St
Fort Worth, TX 76107-7277
Phone (817) 569-4300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240229003647 TX Practitioner - Mental Health Counselor 5991140824 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Texas a & M University System, HSC, College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
My Health My Resources of Tarrant CountyGroup PAC ID 6406755693, 44 clinicians

Practice addresses (Care Compare)

3840 Hulen St
Fort Worth, TX 76107-7277
Phone (817) 569-4300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
83074TXMDProfessional Counselor
15197TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Professional CurrentSince Sep 13, 2024 Accepting new patients
My Health My Resources of Tarrant County CurrentSince Jan 6, 2024 Accepting new patients
My Health My Resources of Tarrant County Past Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

3840 Hulen St
Ft Worth, TX 76107
Phone (817) 569-4395

700 Milam St
Ste 1300
Houston, TX 77002
Phone (281) 801-8391

Organizations & group practices 3

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": "1585699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1316575475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3840 HULEN ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761077277",
            "telephone_number": "817-569-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3840 HULEN ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761077277",
            "telephone_number": "817-335-3022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEAZER",
        "first_name": "COURTNEY",
        "middle_name": "P",
        "credential": "LCDC, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-01",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "83074",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "15197",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.