Active NPI
Bethany L Comeau
- Professional Counselor
- Ft Worth, TX
National Provider Identifier
1356533467
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 64642
- Practice address
- 6731 Poppy Dr
Ft Worth, TX 76137-1871 - Phone
- (602) 295-7200
- Fax
- (602) 295-7200
- NPI assigned
- Aug 13, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Professional Counselor | 101YP2500X | 64642 | TX | Primary |
Addresses
Primary practice location
6731 Poppy Dr
Ft Worth, TX 76137-1871
Mailing address
6731 Poppy Dr
Ft Worth, TX 76137-1871
Phone (602) 295-7200
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 |
|---|---|---|---|
| 64642 | TX | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186963200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1368144000000",
"number": "1356533467",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6731 POPPY DR",
"city": "FT WORTH",
"state": "TX",
"postal_code": "761371871",
"telephone_number": "602-295-7200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6731 POPPY DR",
"city": "FT WORTH",
"state": "TX",
"postal_code": "761371871",
"telephone_number": "602-295-7200",
"fax_number": "602-295-7200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COMEAU",
"first_name": "BETHANY",
"middle_name": "L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-13",
"last_updated": "2013-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "64642",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ft Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.