Kick in the Ass Counseling

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

KICK IN THE ASS COUNSELING

Practice address

4200 South Fwy Ste 520
Fort Worth, TX 76115-1406

Phone

(817) 495-9776

NPI assigned

Jan 16, 2023

Organization subpart

No

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

Authorized official

Name

Victoria Gonzales, LPCNPI 1386266443

Title

Authorized Official

Phone

(817) 495-9776

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Victoria Elizabeth Gonzales, LPC

  • Mental Health Counselor
  • Fort Worth, TX
  • NPI 1386266443
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1673827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729209600000",
    "number": "1982319992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 SOUTH FWY STE 520",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761151406",
            "telephone_number": "817-495-9776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 SOUTH FWY STE 520",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761151406",
            "telephone_number": "817-495-9776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KICK IN THE ASS COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-16",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A",
        "authorized_official_last_name": "GONZALES",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "817-495-9776",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LPC LICENSE",
            "identifier": "86035",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bilal Khoncarly, DO
• Amy Lee Khong, MD
• Shari Khorsandi, FNP
• Raamis Khwaja, MD
• Asim Ahmed Kichloo, M.D.
• Tanya Kidandi
• Janelle Kidd-Spence, PHARMD
• Samantha Chanell Kidd, NP
• Kids & Hugs Home Therapy
• Kids Rise ABA Therapy LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.