Provider Demographics
NPI:1639868839
Name:TUMA, MICHAEL (LPC, LCDC)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
Last Name:TUMA
Suffix:
Gender:M
Credentials:LPC, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7521 LOS PADRES TRL
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76137-3510
Mailing Address - Country:US
Mailing Address - Phone:817-694-0826
Mailing Address - Fax:
Practice Address - Street 1:7521 LOS PADRES TRL
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76137-3510
Practice Address - Country:US
Practice Address - Phone:817-694-0826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-03
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17876101YP2500X
TX10276101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)