Provider Demographics
NPI:1548074362
Name:COWTOWN THERAPY CENTER, PLLC
Entity type:Organization
Organization Name:COWTOWN THERAPY CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KINLEY
Authorized Official - Middle Name:NOELLE
Authorized Official - Last Name:SPRINGS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:682-231-2577
Mailing Address - Street 1:6387 CAMP BOWIE BLVD, STE B, PMB 303
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76116
Mailing Address - Country:US
Mailing Address - Phone:682-231-2577
Mailing Address - Fax:682-292-7535
Practice Address - Street 1:844 PENNSYLVANIA AVE STE 220
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-2269
Practice Address - Country:US
Practice Address - Phone:682-231-2577
Practice Address - Fax:682-292-7535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-03
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty