Organization Active NPI

Wolf Heart Counseling PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fort Worth, TX
National Provider Identifier
1639867104
Registry record updated Apr 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
WOLF HEART COUNSELING PLLC
Practice address
529 Blue Haze Dr
Fort Worth, TX 76108-3957
Phone
(817) 608-7630
Fax
(855) 613-3330
NPI assigned
Apr 24, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2023

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

Authorized official

Name
William Rusnak II, MA, LPC-SNPI 1306363346
Title
Owner/President
Phone
(817) 608-7630

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

529 Blue Haze Dr
Fort Worth, TX 76108-3957

Mailing address

529 Blue Haze Dr
Fort Worth, TX 76108-3957
Phone (817) 608-7630

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1682294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682294400000",
    "number": "1639867104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "529 BLUE HAZE DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761083957",
            "telephone_number": "817-608-7630",
            "fax_number": "855-613-3330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "529 BLUE HAZE DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761083957",
            "telephone_number": "817-608-7630",
            "fax_number": "855-613-3330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOLF HEART COUNSELING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-24",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A",
        "authorized_official_last_name": "RUSNAK",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "817-608-7630",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "MA, LPC-S"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "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 Apr 24, 2023; 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.