Organization
THE TELOS PROJECT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTHONY BEAN PHD (EXECUTIVE DIRECTOR)
(682) 841-1475
Entity
Organization
Contact information
Practice address
7801 OAKMONT BLVD STE 101, FORT WORTH, TX 76132-4242
(682) 841-1475
(682) 708-3775
Mailing address
7801 OAKMONT BLVD STE 101, FORT WORTH, TX 76132-4242
(682) 841-1475
(682) 708-3775
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
367589401
—
TX
Enumeration date
11/10/2016
Last updated
11/01/2023
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