BETH COLALUCA (NPI# 1164507273) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164507273 |
| Entity Type | Individual |
| Full Name | BETH COLALUCA |
| Credential | PHD |
| Practice Address |
1516 Cooper St Fort Worth TX 76104-2710 |
| Mailing Address |
Po Box 99213 Fort Worth TX 76199-0213 |
| Practice Telephone | 6828857450 |
| Practice Fax Number | 6828853600 |
| Mailing Telephone | 6828854871 |
| Mailing Fax Number | 6828853939 |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2009-02-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 31100 | TX | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | AMERIGROUP PIN | 10009180 | 01 |
| TX | BCBSTX IND PIN | 86746A | 01 |
| TX | 040949201 | 05 | |
| TX | FIRSTHEALTH PIN | 2024339 | 01 |
| TX | BCBSTX GRP IPN | 00G981 | 01 |
| TX | UBH PIN | 113406 | 01 |
| TX | PBH PIN | 75205164614 | 01 |
| TX | SUPERIOR PIN | 124105 | 01 |
| GRP NPI NUMBER | 1336198894 | 01 |
| Street Address |
1516 COOPER ST |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76104-2710 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073676656 | Beth M Peterson | Counselor | 1516 Cooper St, Fort Worth, TX 76104-2710 | 2006-12-18 |
| 1518044155 | Samuel V Mccage | Counselor | 1516 Cooper St, Fort Worth, TX 76104-2710 | 2006-11-01 |
| 1982781522 | Lena M Zettler | Psychologist | 1516 Cooper St, Fort Worth, TX 76104-2710 | 2006-11-01 |
| 1184701716 | Kathleen R Shea | Social Worker | 1516 Cooper St, Fort Worth, TX 76104-2710 | 2006-11-01 |
| 1073690608 | Victoria M Mccain | Psychologist | 1516 Cooper St, Fort Worth, TX 76104-2710 | 2006-11-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669082186 | Cvs Pharmacy, Inc. | Durable Medical Equipment & Medical Supplies | 1115 8th St, Fort Worth, TX 76104 | 2020-08-10 |
| 1992343693 | Iris Giove | Psychologist | John Peter Smith Hospital, 1500 S. Main St., Fort Worth, TX 76104 | 2019-12-13 |
| 1104480656 | Swarnalaxmi Umapathy | Student in an Organized Health Care Education/Training Program | 900 8th Avenue, Fort Worth, TX 76104 | 2019-04-30 |
| 1881189132 | Mega Surgical Assistants LLC | Specialist/Technologist, Other | 1301pennsylvania, Fort Worth, TX 76104 | 2018-06-28 |
| 1356848899 | Tricia Kelly | Nurse Practitioner | 1325 Pennsylvania Avenue Suite 560, Fort Worth, TX 76104 | 2018-04-11 |
| 1952820979 | Modern Vein Clinic | Internal Medicine | 757 8th Avenue, Suite A, Forth Worth, TX 76104 | 2017-09-11 |
| 1790207165 | Vanessa Abbood | Dietitian, Registered | 900 Eighth Ave, Fns Department, Fort Worth, TX 76104 | 2017-07-07 |
| 1922537562 | Nicole Marie Tod | Student in an Organized Health Care Education/Training Program | 1500 S Main Street, Fort Worth, TX 76104 | 2017-06-07 |
| 1770025934 | Micah Bonola | Chiropractor | 1300 W. Rosedale St, Ste. A, Fort Worth, TX 76104 | 2016-11-04 |
| 1518315894 | United Bioscience, LLC. | Clinical Medical Laboratory | 901 W. Leuda St., B, Fort Worth, TX 76104 | 2016-05-27 |
| Find all providers in zip 76104 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700101433 | Michael Glenn Hightower | Clinical Neuropsychologist | 6 Lucas Ln, Fort Worth, TX 76134-3407 | 2010-04-06 |
| 1891996963 | Christopher Anagnostis | Clinical Neuropsychologist | 6410 Southwest Blvd, Suite 105, Fort Worth, TX 76109 | 2007-05-29 |
| 1386713691 | Burton J Zung | Clinical Neuropsychologist | 5658 Wescreek Dr Ste 400, Ste 400, Fort Worth, TX 76133 | 2006-11-08 |
| 1962589507 | Marsha T Gabriel | Clinical Neuropsychologist | 429 S Ballinger St, Fort Worth, TX 76104-1008 | 2006-11-01 |
| 1053300350 | Robert P Odgers | Clinical Neuropsychologist | 1814 8th Ave, B, Fort Worth, TX 76110-1354 | 2005-10-19 |
| 1508863036 | Clifford Alan Hopewell | Clinical Neuropsychologist | 1015 Pennsylvania Ave, Ste 2, Fort Worth, TX 76104-2259 | 2005-06-30 |
| 1144860917 | Melissa Edwards Petersen | Clinical Neuropsychologist | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2020-01-09 |
| 1699073114 | Robert Scott Hilborn | Clinical Neuropsychologist | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2011-03-08 |
| 1427084193 | Sidney E O'bryant | Clinical Neuropsychologist | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2006-06-24 |
| 1922060078 | Alan Belmore Frol | Clinical Neuropsychologist | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2006-04-04 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76104 |
Please comment or provide details below to improve the information on BETH COLALUCA.
| 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.