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Organization
MICHELE D. GORTNEY, LPC
Active
Organization
MICHELE D. GORTNEY, LPC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELE D GORTNEY MS, LPC (COUNSELOR/DIRECTOR)
(817) 913-1517
Entity
Organization
Contact information
Practice address
240 E RENFRO ST, SUITE 201, BURLESON, TX 76028-3938
(817) 913-1517
(817) 295-7815
Mailing address
240 E RENFRO ST, SUITE 201, BURLESON, TX 76028-3938
(817) 913-1517
(817) 295-7815
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
19940
TX
1041C0700X
Clinical Social Worker
38240
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
193966202
—
TX
05
—
2092363
—
TX
Enumeration date
02/06/2015
Last updated
02/06/2015
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