| Psychotherapy Services & Yokefellows | |
|
159 N. Riverside Dr Fort Worth TX 76111 | |
| (817) 338-4471 | |
| (817) 338-1811 |
| Full Name | Psychotherapy Services & Yokefellows |
|---|---|
| Speciality | Counselor - Professional |
| Location | 159 N. Riverside Dr, Fort Worth, Texas |
| Authorized Official Name and Position | Ezio Leite (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8173384471 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychotherapy Services & Yokefellows 159 N Riverside Dr Fort Worth TX 76111-3911 Ph: (817) 338-4471 | Psychotherapy Services & Yokefellows 159 N. Riverside Dr Fort Worth TX 76111 Ph: (817) 338-4471 |
| NPI Number | 1124234885 |
|---|---|
| Provider Enumeration Date | 05/16/2007 |
| Last Update Date | 10/04/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124234885 | NPI | - | NPPES |
| 177792201 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (Texas) | Primary |
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