Restore Psychological and Counseling Services

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

70803 Issued in TX

Legal business name

RESTORE PSYCHOLOGICAL AND COUNSELING SERVICES

Practice address

5601 Bridge St
Suite 300
Fort Worth, TX 76112-2384

Phone

(682) 593-1475

Fax

(817) 492-7001

NPI assigned

Jun 29, 2015

Organization subpart

No

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

Authorized official

Name

Kimberly Ann Andrews, LPC

Title

Owner

Phone

(216) 310-8471

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1435536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443139200000",
    "number": "1588046312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5601 BRIDGE ST",
            "address_2": "SUITE 300",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761122384",
            "telephone_number": "682-593-1475",
            "fax_number": "817-492-7001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 BRIDGE ST",
            "address_2": "SUITE 300",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761122384",
            "telephone_number": "682-593-1475",
            "fax_number": "817-492-7001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORE PSYCHOLOGICAL AND COUNSELING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-29",
        "last_updated": "2015-09-25",
        "status": "A",
        "authorized_official_last_name": "ANDREWS",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "216-310-8471",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "70803",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "TX",
            "license": "70803",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2015; 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.