Active NPI
Rose Sulak
- Professional Counselor
- Pantego, TX
National Provider Identifier
1578429767
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 100895
- Practice address
- 3613 W Pioneer Pkwy Ste a
Pantego, TX 76013-4517 - Phone
- (817) 646-6823
- NPI assigned
- Dec 31, 2025
- Last updated
- Dec 31, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 100895 | TX | Primary |
Addresses
Primary practice location
3613 W Pioneer Pkwy Ste a
Pantego, TX 76013-4517
Mailing address
7404 Pebble Ridge Dr
Fort Worth, TX 76132-4307
Phone (817) 646-6823
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 100895 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1767139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1767139200000",
"number": "1578429767",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7404 PEBBLE RIDGE DR",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761324307",
"telephone_number": "817-646-6823"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3613 W PIONEER PKWY STE A",
"city": "PANTEGO",
"state": "TX",
"postal_code": "760134517",
"telephone_number": "817-646-6823"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULAK",
"first_name": "ROSE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-12-31",
"last_updated": "2025-12-31",
"certification_date": "2025-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "100895",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pantego, TX
- Simplicity Counseling Center, LLC
- Sleep Systems (Bedroom Shop)
- Michael Earl Smith, R.PH
- South Arlington Dental Care
- Southwest Arlington Medical Clinic, P.a.
- Andrea Leigh Sullivan, LCSW
- Tender Heart Home Health, LLC (Tender Heart Home Health)
- Tex Cole (first eye care)
- Texas Suburban Visiting Physician Services
- The Family Counseling Center
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.