Provider Demographics
NPI:1841463312
Name:KRODEL, DOREEN (LCSW)
Entity type:Individual
Prefix:MS
First Name:DOREEN
Middle Name:
Last Name:KRODEL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6000 WESTERN PL
Mailing Address - Street 2:SUITE 300
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76107-4607
Mailing Address - Country:US
Mailing Address - Phone:817-570-2230
Mailing Address - Fax:817-570-2231
Practice Address - Street 1:6000 WESTERN PL
Practice Address - Street 2:SUITE 300
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107-4607
Practice Address - Country:US
Practice Address - Phone:817-570-2230
Practice Address - Fax:817-570-2231
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-07
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX293071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical