MR. JIM BYRON ROATEN (NPI# 1861521494) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861521494 |
| Entity Type | Individual |
| Full Name | MR. JIM BYRON ROATEN |
| Credential | MED LPC |
| Practice Address |
5608 Malvey Ave Ste 101 Ft Worth TX 76107-5107 |
| Practice Telephone | 8177373989 |
| Practice Fax Number | 8177375757 |
| Mailing Telephone | 8177373989 |
| Mailing Fax Number | 8177375757 |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2019-07-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | 2996 | TX | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | LPC | 2996 | 01 |
| Street Address |
5608 MALVEY AVE STE 101 |
| City | FT WORTH |
| State | TX |
| Zip Code | 76107-5107 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629683602 | Renovo Wound and Hyperbarics Pllc | Emergency Medicine | 5668 Edwards Ranch Road, Suite 101, Fort Worth, TX 76107 | 2020-09-15 |
| 1669085437 | Ryan Bourgeois | Nurse Practitioner | 2917 Crocket Street, Fort Worth, TX 76107 | 2020-08-31 |
| 1053920546 | Christa Marie Widjaja | Optometrist | 1700 Montgomery St, Fort Worth, TX 76107 | 2020-07-30 |
| 1093351355 | Raymond Iannone | Pharmacist | 850 Montgomery St, Suite #310, Fort Worth, TX 76107 | 2019-11-21 |
| 1053963744 | Cumulus Injury Resolution, Inc. | Chiropractor | 4936 Byers Avenue, Fort Worth, TX 76107 | 2019-07-12 |
| 1770135576 | Shadia Osakwe | Physician Assistant | 855 Montgomery Street, Pediatric Clinic, Fort Worth, TX 76107 | 2019-07-11 |
| 1568945442 | Sachin P Patel | Physical Therapist | 4825 Wellesley St, Fort Worth, TX 76107 | 2018-09-07 |
| 1023594025 | Ftw Pharmacy Services Inc | Durable Medical Equipment & Medical Supplies | 2912 W 6th St Ste 150, Fort Worth, TX 76107 | 2018-07-13 |
| 1669974325 | Helen Williamson Elliott | Counselor | 1751 River Run #217, Fort Worth, TX 76107 | 2018-03-08 |
| 1487156931 | Pelvic Neuromonitoring Pllc | Electrodiagnostic Medicine | 111 Boland St #211, Ft Worth, TX 76107 | 2018-03-01 |
| Find all providers in zip 76107 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740890946 | Alvin Snorton | Counselor | 601 University Dr Ste 112, Ft Worth, TX 76107-2170 | 2020-08-03 |
| 1174035455 | Bright Morning Star Ministries | Counselor | 707 North Fwy Ste 111, Ft Worth, TX 76102-1702 | 2017-10-26 |
| 1710247135 | Laurie Ann Walker | Counselor | 3309 Winthrop Ave Ste 90, Ft Worth, TX 76116-5600 | 2012-05-18 |
| 1699007575 | Ladonna Tennille Covington | Counselor | 100 E. 15th Street, Suite 340, Ft Worth, TX 76102 | 2010-02-03 |
| 1770633935 | Barbara G Howard | Counselor | 2707 Airport Fwy Ste 212, Ft Worth, TX 76111-2370 | 2007-01-11 |
| 1790835064 | Melanie E Hansen | Counselor | 1002 Montgomery St Ste 200, Ft Worth, TX 76107-2693 | 2007-01-11 |
| 1164539516 | Cary Leonard Clark Sr. | Counselor | 6461 Southwest Blvd, Ft Worth, TX 76132 | 2006-08-23 |
| 1821634445 | Brenda A Marsden | Counselor | 4801 Brentwood Stair Rd Ste 404, Ft Worth, TX 76103-1731 | 2019-11-19 |
| 1184181562 | Lanaya L Wood | Counselor | 3309 Winthrop Ave Ste 90, Ft Worth, TX 76116-5600 | 2019-02-21 |
| 1568943983 | Robert Townley | Counselor | 4500 Mercantile Plaza Dr Ste 307, Ft Worth, TX 76137-4230 | 2018-08-23 |
| Find all providers in FT WORTH | ||||
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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.