Victoria Icho, M.S., LMFT ASSOCIATE

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

203547 Issued in TX

Practice address

6551 Harris Pkwy Ste 240
Fort Worth, TX 76132-6103

Phone

(817) 735-4165

Fax

(817) 735-4688

NPI assigned

Jan 19, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Marriage and Family Therapist

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fair Winds Assessment and Counseling Center PLLCGroup PAC ID 9032569280, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Fair Winds Assessment and Counseling Center PLLC

  • Marriage & Family Therapist
  • Fort Worth, TX
  • NPI 1225544877
  Medicare reassignment Care Compare group NPD
• Heather D Perez LPC PLLC

  dba Mindful Solutions Counseling

  • Mental Health Counselor
  • Fort Worth, TX
  • NPI 1851883961

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1642550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1982356291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6551 HARRIS PKWY STE 240",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761326103",
            "telephone_number": "817-735-4165",
            "fax_number": "817-735-4688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6551 HARRIS PKWY STE 240",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761326103",
            "telephone_number": "817-735-4165",
            "fax_number": "817-735-4688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ICHO",
        "first_name": "VICTORIA",
        "name_prefix": "Ms.",
        "credential": "M.S., LMFT ASSOCIATE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-19",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "203547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Marriage & Family Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.