Organization
FOUNDATIONS COUNSELING PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL ADAM BAXTER II LPC-SUPERVISOR (OWNER)
(817) 697-4777
Entity
Organization
Contact information
Practice address
7165 COLLEYVILLE BLVD STE 103, COLLEYVILLE, TX 76034-8011
(817) 697-4777
Mailing address
7165 COLLEYVILLE BLVD STE 103, COLLEYVILLE, TX 76034-8011
(817) 697-4777
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1750707139
NPI 1
—
Enumeration date
06/30/2021
Last updated
02/09/2024
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