| Southstar Counseling Llc | |
|
4204 Staghorn Cir N Fort Worth TX 76137-1121 | |
| (817) 705-0543 | |
| (817) 386-7623 |
| Full Name | Southstar Counseling Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 4204 Staghorn Cir N, Fort Worth, Texas |
| Authorized Official Name and Position | Carl G Cordova (PRESIDENT) |
| Authorized Official Contact | 8177050543 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southstar Counseling Llc Po Box 2512 Fort Worth TX 76113-2512 Ph: (817) 705-0543 | Southstar Counseling Llc 4204 Staghorn Cir N Fort Worth TX 76137-1121 Ph: (817) 705-0543 |
| NPI Number | 1487917274 |
|---|---|
| Provider Enumeration Date | 06/18/2012 |
| Last Update Date | 06/18/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487917274 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 51542 (Texas) | Primary |
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