Individual provider Active NPI

Gerard F Cavanaugh, L.P.C. LMFT-S

  • Professional Counselor
  • Fort Worth, TX
National Provider Identifier
1508917956
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
60121 Issued in TX
Practice address
2928 W 5TH St
Fort Worth, TX 76107-2291
Phone
(817) 332-6348
NPI assigned
Jan 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 201037 TX
Professional Counselor 101YP2500X 60121 TX Primary

Addresses

Primary practice location

2928 W 5TH St
Fort Worth, TX 76107-2291

Mailing address

725 NW Sandra LN
Burleson, TX 76028-3741
Phone (817) 992-8034

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
I20240404003142 TX Practitioner - Mental Health Counselor 1850739194 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

Burleson, TX 76028
Phone (817) 992-8034

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
201037TXMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Medicare Counseling and Therapy LLC CurrentSince Feb 15, 2024 Accepting new patients
The Parenting Center Professional CurrentSince Feb 1, 2024 Accepting new patients
The Center for Family Therapy and Assessment LLC Professional PastSince Feb 15, 2024 Accepting new patients

Locations

2928 W 5th St
Ft Worth, TX 76107
Phone (817) 332-6348

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": "1168732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1508917956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 NW SANDRA LN",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760283741",
            "telephone_number": "817-992-8034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2928 W 5TH ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761072291",
            "telephone_number": "817-332-6348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVANAUGH",
        "first_name": "GERARD",
        "middle_name": "F",
        "credential": "L.P.C.  LMFT-S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-14",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "201037",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "60121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.