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Organization
KICK IN THE ASS COUNSELING
Active
Organization
KICK IN THE ASS COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTORIA GONZALES LPC (AUTHORIZED OFFICIAL)
(817) 495-9776
Entity
Organization
Contact information
Practice address
4200 SOUTH FWY STE 520, FORT WORTH, TX 76115-1406
(817) 495-9776
Mailing address
4200 SOUTH FWY STE 520, FORT WORTH, TX 76115-1406
(817) 495-9776
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86035
LPC LICENSE
TX
Enumeration date
01/16/2023
Last updated
10/18/2024
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