Provider Demographics
NPI:1275872913
Name:THERAPEUTICALLY CHOSEN, LLC
Entity Type:Organization
Organization Name:THERAPEUTICALLY CHOSEN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TERAH
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:817-975-0062
Mailing Address - Street 1:9500 RAY WHITE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-9104
Mailing Address - Country:US
Mailing Address - Phone:817-975-0062
Mailing Address - Fax:469-443-0461
Practice Address - Street 1:9500 RAY WHITE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-9104
Practice Address - Country:US
Practice Address - Phone:817-975-0062
Practice Address - Fax:469-443-0461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-31
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64643101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty