MHMR-TC (NPI# 1063748853) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063748853 |
| Entity Type | Organization |
| Organization Name | MHMR-TC |
| Practice Address |
1200 Circle Drive Ste 400b Ft Worth TX 76119 |
| Mailing Address |
1200 Circle Drive Ste 400b Mhmrtc Ft Worth TX 76119 |
| Practice Telephone | 8175694750 |
| Practice Fax Number | 8175694796 |
| Mailing Telephone | 8175694750 |
| Mailing Fax Number | 8175694796 |
| Enumeration Date | 2009-10-29 |
| Last Update Date | 2009-10-29 |
| Authorized Official Name | DR. JOSEPH BURKETT (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 8175494430 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | 462622 | TX | Agencies |
| Street Address |
1200 CIRCLE DRIVE STE 400B |
| City | FT WORTH |
| State | TX |
| Zip Code | 76119 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467003111 | Asha Jamilia Robertson | Technician | 5321 Rita Kay Ln Lot #21, Fort Worth, TX 76119 | 2019-09-24 |
| 1801366406 | Gina Stovall | Behavioral Analyst | 1100 Circle Drive Suite 101, Fort Worth, TX 76119 | 2018-11-27 |
| 1730660374 | Lisa Alfaro Williams | Counselor | 3120, 22, 24 S.e. Loop 820, Fort Worth, TX 76119 | 2018-08-22 |
| 1023597366 | Gregoire M Butera | Registered Nurse | 3883 Mighty Mite Dr., Fort Worth, TX 76119 | 2018-08-08 |
| 1598244816 | Tawnya R Anderson | Registered Nurse | 3883 Mighty Mite Drive, Fort Worth, TX 76119 | 2018-08-08 |
| 1730699802 | Miller Dental Pllc | Dentist | 3307 Miller Ave Suite #a, Fort Worth, TX 76119 | 2017-10-03 |
| 1053853697 | Carla Walter | Community Health Worker | 4125 Hardeman Ave, Fort Worth, TX 76119 | 2016-11-14 |
| 1710238134 | Thuy Vy Phan | Physician Assistant | 2500 Circle Dr, Fort Worth, TX 76119 | 2012-09-25 |
| 1598031841 | Candace Frances Been | Podiatrist | Federal Bureau of Prisons Federal Medical Center Fort, 3150 Horton Road, Fort Worth, TX 76119 | 2012-03-30 |
| 1053600262 | Miller Dental | Dentist | 3307 Miller Ave Suite A, Fort Worth, TX 76119 | 2011-03-29 |
| Find all providers in zip 76119 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659712057 | Educare Community Living Corporation - Texas | Community/Behavioral Health | 1200 Everman Pkwy, Ft Worth, TX 76140-5002 | 2013-07-13 |
| 1679931547 | Amazing Grace Counseling Services | Community/Behavioral Health | 601 University Dr, 112, Ft Worth, TX 76107-2168 | 2016-02-05 |
| 1861884272 | Choose | Community/Behavioral Health | 2501 Parkview Dr, Ft Worth, TX 76102-5824 | 2015-02-22 |
| 1093013153 | Positive Influences | Community/Behavioral Health | 100 E 15th St, Suite 340, Ft Worth, TX 76102-6550 | 2011-03-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750982047 | Edwards Housing LLC | Community/Behavioral Health | 3119 Teodoro Dr, Grand Prairie, TX 75052-8751 | 2020-11-04 |
| 1457951972 | Allison Evans Counseling and Consulting, Pllc | Community/Behavioral Health | 1584 Seminole Dr, Forney, TX 75126-1450 | 2020-10-26 |
| 1881292738 | Actus Behavioral Support LLC | Community/Behavioral Health | 6213 Smithwick Dr, Mckinney, TX 75070-3573 | 2020-10-13 |
| 1083211387 | Crescent Behavioral Health, LLC | Community/Behavioral Health | 202 W Park Place Dr, Lancaster, TX 75134-3250 | 2020-10-08 |
| 1275130924 | Inspired Action Counseling | Community/Behavioral Health | 14914 Rockledge Dr, Cypress, TX 77429-1874 | 2020-10-06 |
| 1811594450 | Jessica Hooson, Lcsw, P.l.l.c. | Community/Behavioral Health | 516 E Slaughter Ln Apt 402, Austin, TX 78744-0052 | 2020-10-06 |
| 1376150839 | Victoria Behavioral Services Clinic LLC | Community/Behavioral Health | 16205 Westheimer Rd Ste 100, Houston, TX 77082-1207 | 2020-09-29 |
| 1952918682 | Blue Angels Therapeds, LLC | Community/Behavioral Health | 1400 Rivery Blvd Apt 4116, Georgetown, TX 78628-3041 | 2020-09-27 |
| 1659987071 | Committed 2 Me Counseling Center, LLC | Community/Behavioral Health | 105 E. Blackbourn, Hawkins, TX 75765 | 2020-09-21 |
| 1205441383 | Lei Behavioral Services, LLC | Community/Behavioral Health | 6201 Bonhomme Rd # She266n, Houston, TX 77036-4365 | 2020-09-15 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.