MISS BETHANY WALLACE (NPI# 1003388455) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003388455 |
| Entity Type | Individual |
| Full Name | MISS BETHANY WALLACE |
| Credential | LCSW |
| Practice Address |
4686 Bristol Trace Trl Fort Worth TX 76244-6947 |
| Mailing Address |
230 Lace Ln Burleson TX 76028-6736 |
| Practice Telephone | 8177051586 |
| Mailing Telephone | 8177391788 |
| Enumeration Date | 2018-12-26 |
| Last Update Date | 2018-12-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
61687 | TX | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992987754 | Bethany Wallace | Social Worker | 4455 Ne Highway 20, Corvallis, OR 97330 | 2007-12-03 |
| 1740371699 | Bethany Ann Wallace | Family Medicine | 8890 N Union Blvd Ste 170, Colorado Springs, CO 80920-2701 | 2006-09-27 |
| Street Address |
4686 BRISTOL TRACE TRL |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76244-6947 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922406107 | Soo H Lee | Counselor | 4686 Bristol Trace Trl, Fort Worth, TX 76244-6947 | 2014-12-19 |
| 1730508094 | Jenny Gray | Counselor | 4686 Bristol Trace Trl, Fort Worth, TX 76244-6947 | 2014-04-15 |
| 1720403389 | Joe Reed | Counselor | 4686 Bristol Trace Trl, Fort Worth, TX 76244-6947 | 2014-02-19 |
| 1457781395 | Holly Carchesio | Marriage & Family Therapist | 4686 Bristol Trace Trl, Fort Worth, TX 76244-6947 | 2013-11-13 |
| 1992142293 | Jennifer Nicole Martinez | Counselor | 4686 Bristol Trace Trl, Fort Worth, TX 76244-6947 | 2013-05-28 |
| 1619221413 | Sarah Louise Switzer | Counselor | 4686 Bristol Trace Trl, Fort Worth, TX 76244-6947 | 2012-10-31 |
| 1255640397 | Jennifer Marlene Hallcroft | Counselor | 4686 Bristol Trace Trl, Fort Worth, TX 76244-6947 | 2010-10-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538773510 | Aum Nitin Patel | Optometrist | 12584 N Beach Street #122, Keller, TX 76244 | 2020-09-07 |
| 1477178374 | Trinity Spine and Orthopedics, Pllc | Orthopaedic Surgery | 4444 Heritage Trace, Suite 408, Keller, TX 76244 | 2020-06-16 |
| 1235778622 | Hope Family Healthcare LLC | Nurse Practitioner | 4610 Heritage Trace Pkwy, Ste 400, Keller, TX 76244 | 2020-01-02 |
| 1104468917 | Kylie Ann Montgomery | Behavior Technician | 12650 N Beach St Suite 146, Fort Worth, TX 76244 | 2019-10-14 |
| 1376193433 | Ntkc - Dfw, Pllc | Internal Medicine | 10700 Victoria Ash Dr., Keller, TX 76244 | 2019-09-19 |
| 1629628532 | Today Dental of Saginaw Pllc | Dentist | 1628 Basswood Blvd, Fort Worth, TX 76244 | 2019-09-13 |
| 1962050492 | Precision Ambulatory Surgery Center, LLC | Ophthalmology | 9439 North Beach Street, Fort Worth, TX 76244 | 2019-08-28 |
| 1770145351 | Texas Health Spine Surgery Center Alliance LLC | Clinic/Center | 10900 Founders Way, Suite 100, Fort Worth, TX 76244 | 2019-07-03 |
| 1770048720 | Robin Jansen | Occupational Therapy Assistant | 4317 Oak Chase Dr, Keller, TX 76244 | 2019-02-04 |
| 1033687256 | Marian Abibatu James | Nurse Practitioner | 4516 Jaylin St, Keller, TX 76244 | 2018-11-06 |
| Find all providers in zip 76244 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902410756 | Cowtown Counseling Pllc | Social Worker | 3270 Marys Ln, Fort Worth, TX 76116-4328 | 2020-08-31 |
| 1437762770 | Brandi Lashay Rhoden | Social Worker | 1720 Birds Eye Rd, Fort Worth, TX 76177-7548 | 2020-08-26 |
| 1063023067 | Brianna Snow | Social Worker | 2900 Race St Apt 156, Fort Worth, TX 76111-4170 | 2020-08-12 |
| 1871118745 | Raven Temeka Brown-mckinney | Social Worker | 7609 Bancroft Cir, Fort Worth, TX 76120-2491 | 2020-06-16 |
| 1356965123 | Courtney Shipp | Social Worker | 9211 Dale Lane Ct Apt 248, Fort Worth, TX 76108-2655 | 2020-06-08 |
| 1457974966 | Roberta Christine Mcknight-dupas | Social Worker | 6908 Greenlee St, Fort Worth, TX 76112-5602 | 2020-05-19 |
| 1336777010 | Renese Ann Super | Social Worker | 12333 Red Birch Ln, Fort Worth, TX 76244-4597 | 2020-03-30 |
| 1194358499 | Karen Brooks | Social Worker | 8551 Boat Club Rd Ste 115, Fort Worth, TX 76179-3674 | 2020-02-15 |
| 1851922728 | Melissa Dawn Monteiro | Social Worker | 1307 8th Ave Ste 301, Fort Worth, TX 76104-4140 | 2020-01-30 |
| 1417588369 | Ann Keith | Social Worker | 225 Casa Blanca Ave, Fort Worth, TX 76107-7720 | 2020-01-29 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76244 |
Please comment or provide details below to improve the information on MISS BETHANY WALLACE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.