Enderly Place Counseling Center PLLC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

17111 Issued in TX

Legal business name

ENDERLY PLACE COUNSELING CENTER PLLC

Practice address

1706 Enderly PL
Fort Worth, TX 76104-4122

Phone

(817) 207-8055

Fax

(817) 207-8088

NPI assigned

Oct 2, 2008

Organization subpart

No

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

Authorized official

Name

Judy A GaitherNPI 1568563971

Title

Partner

Phone

(817) 207-8055

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Judy Gaither, LPC

  • Counselor
  • Fort Worth, TX
  • NPI 1568563971
  NPD (past) Authorized official

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

{
    "created_epoch": "1222905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222905600000",
    "number": "1770734261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1706 ENDERLY PL",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044122",
            "telephone_number": "817-207-8055",
            "fax_number": "817-207-8088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1706 ENDERLY PL",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044122",
            "telephone_number": "817-207-8055",
            "fax_number": "817-207-8088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDERLY PLACE COUNSELING CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-02",
        "last_updated": "2008-10-02",
        "status": "A",
        "authorized_official_last_name": "GAITHER",
        "authorized_official_first_name": "JUDY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "817-207-8055"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": "TX",
            "license": "17111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Counselor in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2008; 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.