Provider Demographics
NPI:1801082227
Name:MOYERS, JULIE ECKERT (LPC, RPT, NCC)
Entity type:Individual
Prefix:MS
First Name:JULIE
Middle Name:ECKERT
Last Name:MOYERS
Suffix:
Gender:F
Credentials:LPC, RPT, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4344 WESTDALE DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76109-4930
Mailing Address - Country:US
Mailing Address - Phone:817-845-5422
Mailing Address - Fax:817-231-0219
Practice Address - Street 1:1706 ENDERLY PL
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-4122
Practice Address - Country:US
Practice Address - Phone:817-845-5422
Practice Address - Fax:817-231-0219
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-19
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20267101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1811986Medicaid