Provider Demographics
NPI:1245029610
Name:A QUIET CORNER LLC
Entity type:Organization
Organization Name:A QUIET CORNER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:WILLAMETTE
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:817-723-4661
Mailing Address - Street 1:5409 TEMECULA RD
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-6271
Mailing Address - Country:US
Mailing Address - Phone:817-723-4661
Mailing Address - Fax:
Practice Address - Street 1:5409 TEMECULA RD
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-6271
Practice Address - Country:US
Practice Address - Phone:817-723-4661
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-02
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty