Organization Active NPI

Office of Gretchen Fernandez, LCSW, PC

  • Mental Health Counselor
  • Dallas, TX
National Provider Identifier
1629314992
Registry record updated Dec 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
31767 Issued in TX
Legal business name
OFFICE OF GRETCHEN FERNANDEZ, LCSW, PC
Practice address
12830 Hillcrest Rd # D-111
Dallas, TX 75230-1527
Phone
(972) 816-1162
Fax
(972) 364-9095
NPI assigned
Dec 14, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2012

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

Authorized official

Name
Mrs. Gretchen Louise Fernandez, LCSW
Title
Clinician/Therapist
Phone
(972) 816-1162

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 31767 TX Primary

Addresses

Primary practice location

12830 Hillcrest Rd # D-111
Dallas, TX 75230-1527

Mailing address

12830 Hillcrest Rd # D-111
Dallas, TX 75230-1527
Phone (972) 816-1162

National Provider Directory

National Provider Directory

Locations

12830 Hillcrest Rd
Ste D111
Dallas, TX 75230
Phone (972) 816-1162

12830 Hillcrest Rd
#D111
Dallas, TX 75230
Phone (972) 816-1162

300 N Coit Rd
Ste 1175
Richardson, TX 75080
Phone (214) 306-9785

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1355443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355443200000",
    "number": "1629314992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12830 HILLCREST RD # D-111",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752301527",
            "telephone_number": "972-816-1162",
            "fax_number": "972-364-9095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12830 HILLCREST RD # D-111",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752301527",
            "telephone_number": "972-816-1162",
            "fax_number": "972-364-9095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OFFICE OF GRETCHEN FERNANDEZ, LCSW, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-14",
        "last_updated": "2012-12-14",
        "status": "A",
        "authorized_official_last_name": "FERNANDEZ",
        "authorized_official_first_name": "GRETCHEN",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "CLINICIAN/THERAPIST",
        "authorized_official_telephone_number": "972-816-1162",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "31767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2012; 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.