LAKE WORTH COUNSELING NPI 1194085506

NPI Information

  • NPI: 1194085506
  • Provider Name: LAKE WORTH COUNSELING
  • Classification: Counselor - 101YM0800X
  • Specialization: Mental Health
  • Entity Type: Organization
  • Former Legal Business Name: SUSAN SCHLOSSER
  • CLIA Number: 45D1030404
  • Address: 4516 BOAT CLUB RD
    STE 106
    FORT WORTH, TX
    ZIP 76135
  • Phone: (682) 556-9096

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NPI Details

LAKE WORTH COUNSELING is a mental health counselor in Fort Worth, TX. LAKE WORTH COUNSELING NPI is 1194085506. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Susan Schlosser.

The provider's business location address is:

4516 BOAT CLUB RD
STE 106
FORT WORTH, TX
ZIP 76135-019
Phone: (682) 556-9096
Fax: (817) 238-8333

The provider's authorized official is Susan Schlosser .
The authorized official title is Owner and has the following contact phone number (682) 556-9096.

The CLIA number assigned to this NPI record is 45D1030404 - ambulance with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/18/2012 and was last updated on 10/27/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1106H00000XMarriage & Family Therapist5110TEXASNo
2101YM0800XCounselorMental Health17834TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1206698701MEDICARE PINTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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