Organization Active NPI

Cowtown Christian Counseling PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fort Worth, TX
National Provider Identifier
1760064067
Registry record updated Apr 26, 2021
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
COWTOWN CHRISTIAN COUNSELING PLLC
Practice address
1751 River Run Ste 242
Fort Worth, TX 76107-6645
Phone
(682) 438-7154
NPI assigned
Apr 26, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2021

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

Authorized official

Name
Joel Peterson, LPCNPI 1982279014
Title
Therapist
Phone
(682) 438-7154

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

1751 River Run Ste 242
Fort Worth, TX 76107-6645

Mailing address

5589 Red Cardinal LN
Fort Worth, TX 76114-3620

National Provider Directory

National Provider Directory

Locations

1751 River Run
Ste 242
Fort Worth, TX 76107
Phone (682) 438-7154

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": "1619395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619395200000",
    "number": "1760064067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5589 RED CARDINAL LN",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761143620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1751 RIVER RUN STE 242",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761076645",
            "telephone_number": "682-438-7154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COWTOWN CHRISTIAN COUNSELING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-26",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "JOEL",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "682-438-7154",
        "authorized_official_credential": "LPC"
    },
    "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 26, 2021; 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.