Provider Demographics
NPI:1952691974
Name:MENTAL HEALTH ASSOCIATION OF TARRANT COUNTY
Entity Type:Organization
Organization Name:MENTAL HEALTH ASSOCIATION OF TARRANT COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LEE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEGRICE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LCSW
Authorized Official - Phone:817-335-5405
Mailing Address - Street 1:3136 W 4TH ST
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76107-2113
Mailing Address - Country:US
Mailing Address - Phone:817-335-5405
Mailing Address - Fax:817-334-0025
Practice Address - Street 1:3136 W 4TH ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107-2113
Practice Address - Country:US
Practice Address - Phone:817-335-5405
Practice Address - Fax:817-334-0025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-11
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health