Individual provider Active NPI

Robert Joseph Pitre Sr., LMSW-ACP

  • Mental Health Counselor
  • Benbrook, TX
National Provider Identifier
1881644664
Registry record updated Jul 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
S17899 Issued in TX
Practice address
6410 Southwest Blvd Ste 230
Benbrook, TX 76109-6920
Phone
(817) 335-5489
Fax
(817) 335-7242
NPI assigned
May 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1063 TX
Mental Health Counselor 101YM0800X S17899 TX Primary

Addresses

Primary practice location

6410 Southwest Blvd Ste 230
Benbrook, TX 76109-6920

Mailing address

4300 Cumberland Rd N
Fort Worth, TX 76116-8106
Phone (817) 703-3210

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150818004021 TX Practitioner - Clinical Social Worker 0244545457 Practice locations: Benbrook, TX

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1966
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6410 Southwest Blvd
Suite 230
Benbrook, TX 76109-6920
Phone (817) 335-5489

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S17899TXMDMental Health Counselor
17899TXMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564012800000",
    "number": "1881644664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 CUMBERLAND RD N",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761168106",
            "telephone_number": "817-703-3210",
            "fax_number": "817-335-7242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6410 SOUTHWEST BLVD STE 230",
            "city": "BENBROOK",
            "state": "TX",
            "postal_code": "761096920",
            "telephone_number": "817-335-5489",
            "fax_number": "817-335-7242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITRE",
        "first_name": "ROBERT",
        "middle_name": "JOSEPH",
        "name_suffix": "Sr.",
        "credential": "LMSW-ACP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2019-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "1063",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "S17899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Benbrook, TX

Sources for this page

Verify at the official NPI Registry.