Gaither, Judy
Gaither, Judy is an sole proprietor health care provider with primary practice located at 1706 Enderly Place , Fort Worth TX 76104. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Counselor is her primary health care specialty. Gaither, Judy can be contacted via phone (817) 614-6041.Contact Information
Primary practice address
1706 Enderly Place
Fort Worth TX 76104
Phone: (817) 614-6041
Fax: (817) 207-8088
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Counselor | 101Y00000X | 17111 | Texas |
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 17111 | Texas |
Profile Details
| NPI number | 1568563971 |
|---|---|
| LBN Legal business name | Gaither, Judy |
| Credentials | Licensed Professional Counselor (LPC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 26th, 2006 |
| Last updated | Sep 27th, 2012 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1568563971 | NPPES |
| Texas | MEDICAID | 157081402 |
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