Mary Beth Dennie, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

62443 Issued in TX

Practice address

418 Eureka St
Weatherford, TX 76086-5439

Phone

(817) 629-9132

Fax

(817) 594-9995

NPI assigned

Feb 13, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1202860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259884800000",
    "number": "1568630432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 EUREKA ST",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760865439",
            "telephone_number": "817-629-9132",
            "fax_number": "817-594-9995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 EUREKA ST",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760865439",
            "telephone_number": "817-629-9132",
            "fax_number": "817-594-9995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENNIE",
        "first_name": "MARY",
        "middle_name": "BETH",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-13",
        "last_updated": "2009-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "62443",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "192250202",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "192250201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Nikki Dennis
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• Kelly Jean Detherage, PTA
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• DGNM,LLC Dba Heart in Hand

• Mental Health Counselor in Weatherford, TX
• Providers in Weatherford, TX by specialty
• Mental Health Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2009; 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.