Provider Demographics
NPI:1790595056
Name:LADD, SUMMER (LPC-A)
Entity type:Individual
Prefix:
First Name:SUMMER
Middle Name:
Last Name:LADD
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4417 CHAPARRAL CT
Mailing Address - Street 2:
Mailing Address - City:ALVARADO
Mailing Address - State:TX
Mailing Address - Zip Code:76009-8596
Mailing Address - Country:US
Mailing Address - Phone:817-480-6094
Mailing Address - Fax:
Practice Address - Street 1:2630 WEST FWY STE 120
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76102-7117
Practice Address - Country:US
Practice Address - Phone:817-480-6094
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-09
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX96575101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor