Provider Demographics
NPI:1508940776
Name:COUNSELING AND RESOURCE ENDORSEMENT, INC.
Entity Type:Organization
Organization Name:COUNSELING AND RESOURCE ENDORSEMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:LIVESAY
Authorized Official - Suffix:
Authorized Official - Credentials:MSSW/LCSW
Authorized Official - Phone:817-239-1114
Mailing Address - Street 1:2944 HEMPHILL ST
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76110-6501
Mailing Address - Country:US
Mailing Address - Phone:817-239-1114
Mailing Address - Fax:817-926-8983
Practice Address - Street 1:2944 HEMPHILL ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76110-6501
Practice Address - Country:US
Practice Address - Phone:817-239-1114
Practice Address - Fax:817-926-8983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX329661041C0700X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX83625WMedicare ID - Type Unspecified