| Fort Worth Brief Therapy Center | |
|
1400 S Main St Suite 509 Fort Worth TX 76104-4909 | |
| (817) 870-1080 | |
| (817) 870-1085 |
| Full Name | Fort Worth Brief Therapy Center |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1400 S Main St, Fort Worth, Texas |
| Authorized Official Name and Position | Elliott Eugene Connie (CO-DIRECTOR, ASSOCIATE THERAPIST) |
| Authorized Official Contact | 8178701080 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fort Worth Brief Therapy Center 1400 S Main St Suite 509 Fort Worth TX 76104-4909 Ph: (817) 870-1080 | Fort Worth Brief Therapy Center 1400 S Main St Suite 509 Fort Worth TX 76104-4909 Ph: (817) 870-1080 |
| NPI Number | 1730215724 |
|---|---|
| Provider Enumeration Date | 02/26/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730215724 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | 62681 (Texas) | Primary |
| 101YM0800X | Counselor - Mental Health | 62681 (Texas) | Primary |
| 101YP2500X | Counselor - Professional | 62681 (Texas) | Primary |
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