NPIMap

Organization Active NPI

The Telos Project

  • Clinical Psychologist
  • Fort Worth, TX
National Provider Identifier
1457893232
Registry record updated Nov 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
THE TELOS PROJECT
Practice address
7801 Oakmont Blvd Ste 101
Fort Worth, TX 76132-4242
Phone
(682) 841-1475
Fax
(682) 708-3775
NPI assigned
Nov 10, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2023

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

Authorized official

Name
Dr. Anthony Bean, PHDNPI 1831471697
Title
Executive Director
Phone
(682) 841-1475

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

7801 Oakmont Blvd Ste 101
Fort Worth, TX 76132-4242

Mailing address

7801 Oakmont Blvd Ste 101
Fort Worth, TX 76132-4242
Phone (682) 841-1475

Other identifiers 1

IdentifierTypeStateIssuer
367589401MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170123000540 TX Part B Supplier - Clinic/Group Practice 1153603469 Receives reassigned benefits from 9 practitioners
Practice locations: Fort Worth, TX

National Provider Directory

National Provider Directory

Locations

226 Bailey Ave
Ste 103
Fort Worth, TX 76107
Phone (682) 231-2420

Practitioners & affiliated clinicians

Practitioners 10

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

NPI Registry JSON

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

{
    "created_epoch": "1478736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698796800000",
    "number": "1457893232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7801 OAKMONT BLVD STE 101",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761324242",
            "telephone_number": "682-841-1475",
            "fax_number": "682-708-3775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7801 OAKMONT BLVD STE 101",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761324242",
            "telephone_number": "682-841-1475",
            "fax_number": "682-708-3775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE TELOS PROJECT",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-10",
        "last_updated": "2023-11-01",
        "certification_date": "2023-11-01",
        "status": "A",
        "authorized_official_last_name": "BEAN",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "682-841-1475",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "367589401",
            "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 Nov 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.