MR. LAURENCE SAPUTRA (NPI# 1588166755) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588166755 |
| Entity Type | Individual |
| Full Name | MR. LAURENCE SAPUTRA |
| Credential | LPC |
| Practice Address |
4232 Heritage Trace Pkwy Fort Worth TX 76244-5375 |
| Practice Telephone | 8174473001 |
| Practice Fax Number | 8172895699 |
| Mailing Telephone | 8174473001 |
| Mailing Fax Number | 8172895699 |
| Enumeration Date | 2018-03-05 |
| Last Update Date | 2018-03-05 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
75981 | TX | Behavioral Health & Social Service Providers |
| Street Address |
4232 HERITAGE TRACE PKWY |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76244-5375 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932254679 | Envision Imaging of North Fort Worth | Radiology | 4232 Heritage Trace Pkwy, Fort Worth, TX 76244-5375 | 2007-01-24 |
| 1609419134 | Jessica Renae Carr | Nurse Practitioner | 4232 Heritage Trace Pkwy, Fort Worth, TX 76244-5375 | 2019-10-28 |
| 1144704552 | Dominique Dacus | Counselor | 4232 Heritage Trace Pkwy, Fort Worth, TX 76244-5375 | 2018-09-20 |
| 1528542594 | Erika Rodriguez Lozano | Counselor | 4232 Heritage Trace Pkwy, Fort Worth, TX 76244-5375 | 2018-09-17 |
| 1962983767 | Michelle Gay Mcmillan | Counselor | 4232 Heritage Trace Pkwy, Fort Worth, TX 76244-5375 | 2018-08-28 |
| 1356859185 | Tricia Tillman | Counselor | 4232 Heritage Trace Pkwy, Fort Worth, TX 76244-5375 | 2018-01-15 |
| 1023528775 | Cathleen Ricks | Counselor | 4232 Heritage Trace Pkwy, Fort Worth, TX 76244-5375 | 2017-10-09 |
| 1275905937 | Deann Harrison | Nurse Practitioner | 4232 Heritage Trace Pkwy, Fort Worth, TX 76244-5375 | 2015-10-21 |
| 1750777850 | Shawntee Desaray Goff | Social Worker | 4232 Heritage Trace Pkwy, Fort Worth, TX 76244-5375 | 2015-04-15 |
| 1346639085 | Constance Canada | Counselor | 4232 Heritage Trace Pkwy, Fort Worth, TX 76244-5375 | 2015-01-19 |
| Find all providers in the same location | ||||
| 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 | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063013043 | Shayla H Rumsey | Counselor | 1137f Burton Hill Rd, Fort Worth, TX 76114-4530 | 2020-11-05 |
| 1356942544 | Abigail Ibitoye | Counselor | 6300 Ridglea Pl Ste 425, Fort Worth, TX 76116-5704 | 2020-11-04 |
| 1932713385 | Brooke Nicole Powell | Counselor | 1804 Glenmore Ave, Fort Worth, TX 76102-1509 | 2020-09-03 |
| 1669085254 | Heather Marie Wolf | Counselor | 429 College Ave Apt 301, Fort Worth, TX 76104-2264 | 2020-08-25 |
| 1013529361 | Michelle Mcqueen | Counselor | 8548 S Hulen St, Fort Worth, TX 76123-2741 | 2020-08-18 |
| 1871102772 | Precious Victoria Robinson | Counselor | 929 E Pulaski St, Fort Worth, TX 76104-5139 | 2020-07-27 |
| 1861010258 | Rachel Brohammer | Counselor | 4005 Ohare Ct Apt 602, Fort Worth, TX 76155-2853 | 2020-07-11 |
| 1972128288 | Traci Cocetti | Counselor | 4516 Fletcher Ave, Fort Worth, TX 76107-6214 | 2020-06-11 |
| 1285259622 | Brittany Lynn Stroud | Counselor | 3200 Riverfront Dr Ste 108, Fort Worth, TX 76107-6560 | 2020-06-11 |
| 1912529330 | Kristen Ann Mcgowen-plaga | Counselor | 12729 Homestretch Dr, Fort Worth, TX 76244-4214 | 2020-05-07 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76244 |
Please comment or provide details below to improve the information on MR. LAURENCE SAPUTRA.
| 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.