Provider Demographics
NPI:1477163103
Name:SPEIKER, ADRIANA E (LPC)
Entity Type:Individual
Prefix:
First Name:ADRIANA
Middle Name:E
Last Name:SPEIKER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3509 HULEN ST STE 251
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76107-6867
Mailing Address - Country:US
Mailing Address - Phone:817-764-3801
Mailing Address - Fax:
Practice Address - Street 1:3509 HULEN ST STE 251
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107-6867
Practice Address - Country:US
Practice Address - Phone:817-764-3801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-07
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX75249101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional