Provider Demographics
NPI:1881644664
Name:PITRE, ROBERT JOSEPH SR (LMSW-ACP)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:JOSEPH
Last Name:PITRE
Suffix:SR
Gender:M
Credentials:LMSW-ACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 CUMBERLAND RD N
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76116-8106
Mailing Address - Country:US
Mailing Address - Phone:817-703-3210
Mailing Address - Fax:817-335-7242
Practice Address - Street 1:6410 SOUTHWEST BLVD STE 230
Practice Address - Street 2:
Practice Address - City:BENBROOK
Practice Address - State:TX
Practice Address - Zip Code:76109-6920
Practice Address - Country:US
Practice Address - Phone:817-335-5489
Practice Address - Fax:817-335-7242
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-11
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1063101YA0400X
TXS17899101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)