Individual
CHAVA SHIRA ROUSCH-CARLISLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, APHSW-C
Contact information
Practice address
3210 W PARK ROW DR, PANTEGO, TX 76013-3136
(817) 692-6917
Mailing address
1418 W PIPELINE RD # 103, HURST, TX 76053-4629
(817) 692-6917
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
63773
TX
Other
Enumeration date
02/08/2022
Last updated
01/23/2024
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