Fort Worth Brief Therapy Center, PLLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

62762 Issued in TX

Legal business name

FORT WORTH BRIEF THERAPY CENTER, PLLC

Practice address

3113 S University Dr
Ste 201
Ft Worth, TX 76109-5616

Phone

(817) 923-1444

Fax

(817) 923-1490

NPI assigned

Jan 25, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Mathew A. Trammell, LPC-SNPI 1396870929

Title

Co-Owner

Phone

(817) 301-6322

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Fort Worth Brief Therapy Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Fort Worth Brief Therapy Center

  • Counselor
  • Fort Worth, TX
  • NPI 1730215724
  NPD tax ID

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mathew A Trammell, LPC-S

  • Professional Counselor
  • Fort Worth, TX
  • NPI 1396870929
  Authorized official Same address or phone
• Robin Dickey, LPC-INTERN

  • Mental Health Counselor
  • Fort Worth, TX
  • NPI 1790073930
  NPD (past)
• Blaine Moore, LCSW

  • Clinical Social Worker
  • Mansfield, TX
  • NPI 1346388659
  NPD (past)

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

{
    "created_epoch": "1359072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359072000000",
    "number": "1417295445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 US HIGHWAY 287",
            "address_2": "SUITE 1",
            "city": "RHOME",
            "state": "TX",
            "postal_code": "760784323",
            "telephone_number": "817-301-6322",
            "fax_number": "817-923-1490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3113 S UNIVERSITY DR",
            "address_2": "STE 201",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761095616",
            "telephone_number": "817-923-1444",
            "fax_number": "817-923-1490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT WORTH BRIEF THERAPY CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-25",
        "last_updated": "2013-01-25",
        "status": "A",
        "authorized_official_last_name": "TRAMMELL",
        "authorized_official_first_name": "MATHEW",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "817-301-6322",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPC-S"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "62762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "219912701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fort Wellness, PLLC
• Fort Worth Allergy and Asthma Associates, LLP
• Fort Worth Birthing & Wellness Center
• Fort Worth Brain & Spine Institute, LLP
• Fort Worth Brief Therapy Center
• Fort Worth Cancer Care, PLLC
• Fort Worth Cardiovascular Center, L.P.
• Fort Worth Children's Speech and Feeding Therapy, PLLC
• Fort Worth Chiropractic Clinic PLLC
• Fort Worth Clinic Specialty Care, PLLC

• Professional Counselor in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 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.

Verify at the official NPI Registry.