Active NPI
Matthew Bacchus, LPC
- Professional Counselor
- Fort Worth, TX
National Provider Identifier
1831984186
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC.101075
- Practice address
- 2632 Prospect Ridge Dr
Fort Worth, TX 76110-2575 - Phone
- (915) 497-8495
- NPI assigned
- Apr 9, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | PC.0022108 | CO | |
| Professional Counselor | 101YP2500X | LPC.101075 | TX | Primary |
Addresses
Primary practice location
2632 Prospect Ridge Dr
Fort Worth, TX 76110-2575
Mailing address
2632 Prospect Ridge Dr
Fort Worth, TX 76110-2575
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 30, 2025 through Apr 30, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PC.0022108 | CO | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1744156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1831984186",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2632 PROSPECT RIDGE DR",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761102575"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2632 PROSPECT RIDGE DR",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761102575",
"telephone_number": "915-497-8495"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BACCHUS",
"first_name": "MATTHEW",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-04-09",
"last_updated": "2026-07-13",
"certification_date": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CO",
"license": "PC.0022108",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Professional",
"state": "TX",
"license": "LPC.101075",
"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 Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.