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Organization

COUNTRY PLACE COUNSELING, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. JANET L. DOUGLAS LCSW (OWNER/MEMBER MANAGER)
(817) 228-4855
Entity
Organization

Contact information

Practice address
4255 BRYANT IRVIN RD, SUITE 101, FORT WORTH, TX 76109-4233
(817) 228-4855
(817) 735-9404
Mailing address
4255 BRYANT IRVIN RD, SUITE 101, FORT WORTH, TX 76109-4233
(817) 228-4855
(817) 735-9404

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
30116
TX

Other

Enumeration date
06/10/2010
Last updated
06/16/2010
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