Intimacy Counseling & Consulting

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Legal business name

INTIMACY COUNSELING & CONSULTING

Practice address

3900 Merrett Dr Ste C
Fort Worth, TX 76135-2920

Phone

(903) 466-2643

NPI assigned

Jul 10, 2023

Organization subpart

No

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

Authorized official

Name

Federico Mendez, LMFT

Title

Ceo/Owner

Phone

(817) 631-9991

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1688947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705968000000",
    "number": "1861170839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4553 GLENVIEW CT",
            "city": "NORTH RICHLAND HILLS",
            "state": "TX",
            "postal_code": "761807349",
            "telephone_number": "903-466-2643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 MERRETT DR STE C",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761352920",
            "telephone_number": "903-466-2643"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4304 SW Green Oaks Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "TX",
            "postal_code": "760172367",
            "country_code": "US",
            "telephone_number": "903-466-2643",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INTIMACY COUNSELING & CONSULTING",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-10",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A",
        "authorized_official_last_name": "MENDEZ",
        "authorized_official_first_name": "FEDERICO",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "817-631-9991",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2024; 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.