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Organization
PROFESSIONAL COUNSELING CENTER PLLC
Active
Organization
PROFESSIONAL COUNSELING CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. YVETTE PHILLIPS PSYD (CLINICAL DIRECTOR)
(817) 306-9770
Entity
Organization
Contact information
Practice address
6612 N RIVERSIDE DR, SUITE 140, FORT WORTH, TX 76137-6663
(817) 306-9770
(817) 306-0664
Mailing address
6612 N RIVERSIDE DR, SUITE 140, FORT WORTH, TX 76137-6663
(817) 306-9770
(817) 306-0664
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
63253
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1883613-01
—
TX
Enumeration date
03/03/2008
Last updated
06/20/2008
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