MR. JACOB O WASONGA (NPI# 1861043713) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861043713 |
| Entity Type | Individual |
| Full Name | MR. JACOB O WASONGA |
| Credential | LMFT |
| Practice Address |
1124 Galveston Ave Ste B Fort Worth TX 76104-4878 |
| Practice Telephone | 2104208117 |
| Mailing Telephone | 2104208117 |
| Enumeration Date | 2019-09-23 |
| Last Update Date | 2019-09-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | 203024 | TX | Behavioral Health & Social Service Providers |
| Street Address |
1124 GALVESTON AVE STE B |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76104-4878 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669082186 | Cvs Pharmacy, Inc. | Durable Medical Equipment & Medical Supplies | 1115 8th St, Fort Worth, TX 76104 | 2020-08-10 |
| 1992343693 | Iris Giove | Psychologist | John Peter Smith Hospital, 1500 S. Main St., Fort Worth, TX 76104 | 2019-12-13 |
| 1104480656 | Swarnalaxmi Umapathy | Student in an Organized Health Care Education/Training Program | 900 8th Avenue, Fort Worth, TX 76104 | 2019-04-30 |
| 1881189132 | Mega Surgical Assistants LLC | Specialist/Technologist, Other | 1301pennsylvania, Fort Worth, TX 76104 | 2018-06-28 |
| 1356848899 | Tricia Kelly | Nurse Practitioner | 1325 Pennsylvania Avenue Suite 560, Fort Worth, TX 76104 | 2018-04-11 |
| 1952820979 | Modern Vein Clinic | Internal Medicine | 757 8th Avenue, Suite A, Forth Worth, TX 76104 | 2017-09-11 |
| 1790207165 | Vanessa Abbood | Dietitian, Registered | 900 Eighth Ave, Fns Department, Fort Worth, TX 76104 | 2017-07-07 |
| 1922537562 | Nicole Marie Tod | Student in an Organized Health Care Education/Training Program | 1500 S Main Street, Fort Worth, TX 76104 | 2017-06-07 |
| 1770025934 | Micah Bonola | Chiropractor | 1300 W. Rosedale St, Ste. A, Fort Worth, TX 76104 | 2016-11-04 |
| 1518315894 | United Bioscience, LLC. | Clinical Medical Laboratory | 901 W. Leuda St., B, Fort Worth, TX 76104 | 2016-05-27 |
| Find all providers in zip 76104 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679173017 | Christina Helen Grudzinski | Marriage & Family Therapist | 6777 Camp Bowie Blvd Ste 332, Fort Worth, TX 76116-7196 | 2020-10-26 |
| 1174157325 | Deitra Baker | Marriage & Family Therapist | 9800 Hillwood Pkwy, Fort Worth, TX 76177-1527 | 2020-02-26 |
| 1831759208 | James Michael Jeffcoat | Marriage & Family Therapist | 4700 Bryant Irvin Ct Ste 203, Fort Worth, TX 76107-7645 | 2019-06-18 |
| 1154829455 | Edlyn Quintero | Marriage & Family Therapist | 226 Bailey Ave Ste 103, Fort Worth, TX 76107-1260 | 2018-02-01 |
| 1902335680 | New Horizon Counseling | Marriage & Family Therapist | 4255 Bryant Irvin Rd Ste 210, Fort Worth, TX 76109-4225 | 2017-06-07 |
| 1346786233 | Sunday Dieke | Marriage & Family Therapist | 10000 Calcite Dr, Fort Worth, TX 76131-3398 | 2017-01-16 |
| 1265899595 | Deliliah Lemons | Marriage & Family Therapist | 1512 W Gambrell St, Fort Worth, TX 76115-2207 | 2016-01-17 |
| 1134584501 | Carolyn V Becker | Marriage & Family Therapist | 4700 Keller Hicks Rd, Fort Worth, TX 76244-9663 | 2015-12-29 |
| 1114309101 | Zully Schultz | Marriage & Family Therapist | 1509b S. University Dr., Suite 212, Fort Worth, TX 76107 | 2015-06-25 |
| 1932580735 | Jenifer Costigan | Marriage & Family Therapist | 1509b S. University Dr, 212, Fort Worth, TX 76107-9501 | 2015-06-17 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76104 |
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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.