NPIMap

Individual provider Active NPI

Judith Presley, LCDC

  • Addiction (Substance Use Disorder) Counselor
  • Fort Worth, TX
National Provider Identifier
1548852148
Registry record updated Feb 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
14736 Issued in TX
Practice address
4801 Brentwood Stair Rd Ste 404
Fort Worth, TX 76103-1731
Phone
(817) 492-9383
NPI assigned
Feb 5, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X TX
Addiction (Substance Use Disorder) Counselor 101YA0400X 14736 TX Primary

Addresses

Primary practice location

4801 Brentwood Stair Rd Ste 404
Fort Worth, TX 76103-1731

Mailing address

4801 Brentwood Stair Rd Ste 404
Fort Worth, TX 76103-1731
Phone (817) 492-9383

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Treatment Services LLC PastSince Feb 7, 2021 Accepting new patients
Symetria Health of Texas, LLC Past Accepting new patients
Symetria Health of Texas, LLC Past Accepting new patients
Symetria Health of Texas, LLC Past Accepting new patients
Symetria Health of Texas, L.L.C. Past Accepting new patients
Texas Treatment Services, LLC PastSince Feb 7, 2021 Accepting new patients
Symetria Health of Texas, L.L.C. Past Accepting new patients
Symetria Health of Texas, LLC Past Accepting new patients

Organizations & group practices 8

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": "1612483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612483200000",
    "number": "1548852148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 BRENTWOOD STAIR RD STE 404",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761031731",
            "telephone_number": "817-492-9383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 BRENTWOOD STAIR RD STE 404",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761031731",
            "telephone_number": "817-492-9383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESLEY",
        "first_name": "JUDITH",
        "credential": "LCDC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-05",
        "last_updated": "2021-02-05",
        "certification_date": "2021-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "14736",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Feb 5, 2021; 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.