Individual
MS. SUSAN WEEKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RN, LMFT, LCDC
Contact information
Practice address
5608 MALVEY AVE, SUITE 306, FORT WORTH, TX 76107-5100
(817) 737-5599
(817) 737-5757
Mailing address
5608 MALVEY AVE, SUITE 306, FORT WORTH, TX 76107-5100
(817) 737-5599
(817) 737-5757
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
3902
TX
106H00000X
Marriage & Family Therapist
1815
TX
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
520122
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CCP004944
—
TX
Enumeration date
03/24/2007
Last updated
09/07/2007
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