Canary Ridge Counseling PLLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

CANARY RIDGE COUNSELING PLLC

Practice address

2501 Parkview Dr Ste 316E
Fort Worth, TX 76102-5824

Phone

(817) 692-5467

NPI assigned

Dec 11, 2019

Last updated

Dec 11, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jennifer Beaman, LPC

Title

Owner

Phone

(817) 692-5467

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1576022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576022400000",
    "number": "1477191385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 PARKVIEW DR STE 316E",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761025824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 PARKVIEW DR STE 316E",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761025824",
            "telephone_number": "817-692-5467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANARY RIDGE COUNSELING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-11",
        "last_updated": "2019-12-11",
        "certification_date": "2019-12-11",
        "status": "A",
        "authorized_official_last_name": "BEAMAN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-692-5467",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Community/Behavioral Health Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2019; 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.