MRS. MERRILL L LITTLEBERRY (NPI# 1649235060) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649235060 |
| Entity Type | Individual |
| Full Name | MRS. MERRILL L LITTLEBERRY |
| Credential | LCSW, LCDC, CCM |
| Practice Address |
4200 South Fwy Suite 424 Fort Worth TX 76115-1400 |
| Practice Telephone | 8179209321 |
| Practice Fax Number | 8179209336 |
| Mailing Telephone | 8179209321 |
| Mailing Fax Number | 8179209336 |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
9615 | TX | Behavioral Health & Social Service Providers |
| X | 1041C0700X |
Social Worker Specialization: Clinical |
28682 | TX | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | VALUE OPTIONS | 560613 | 01 |
| TX | HORIZON HEALTH | 63003 | 01 |
| TX | BC/BS | 51MX | 01 |
| Street Address |
4200 SOUTH FWY SUITE 424 |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76115-1400 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366086589 | Uma Deepthi Potluri | Dentist | 4200 South Fwy, Fort Worth, TX 76115-1400 | 2019-10-31 |
| 1194203695 | Jan L Birks | Counselor | 4200 South Fwy, Fort Worth, TX 76115-1400 | 2018-08-06 |
| 1609375658 | Sowmya Renuka | Dentist | 4200 South Fwy, Fort Worth, TX 76115-1400 | 2018-02-05 |
| 1942616784 | Parthenia Harden | Licensed Vocational Nurse | 4200 South Fwy, 800, Fort Worth, TX 76115-1400 | 2014-07-01 |
| 1134534753 | Judy Jones | Licensed Vocational Nurse | 4200 South Fwy, Suite 800, Fort Worth, TX 76115-1400 | 2014-06-23 |
| 1780920884 | Familia Care Inc | Pharmacy | 4200 South Fwy, Suite 106, Fort Worth, TX 76115-1400 | 2012-12-17 |
| 1902159676 | Julio Augusto Valdes Salinas | Pediatrics | 4200 South Fwy, Suite 106, Fort Worth, TX 76115-1400 | 2012-10-18 |
| 1629329891 | Ismile Dental At La Gran Plaza, Pllc | Dentist | 4200 South Fwy, Suite 1550, Fort Worth, TX 76115-1400 | 2012-09-27 |
| 1912285420 | Won Jun Jung | Dentist | 4200 South Fwy, Suite 805, Fort Worth, TX 76115-1400 | 2011-08-01 |
| 1902191703 | Seyed Masood Shariati | Dentist | 4200 South Fwy, Suite 805, Fort Worth, TX 76115-1400 | 2011-06-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811400047 | Christine Vera Varela | Nurse Practitioner | Clinicas Mi Doctor, 4200 S Freeway Ste 106, Fort Worth, TX 76115 | 2017-11-09 |
| 1376081752 | Cheryl D. Mitchell | Nurse Practitioner | 11803 S. Freeway, Ste. 311, Fort Worth, TX 76115 | 2017-02-06 |
| 1508097858 | Misti Lynne Poulos | Massage Therapist | 4534 Stanley Ave, #361, Fort Worth, TX 76115 | 2009-08-04 |
| 1609015312 | Sirisha Bheemaneni | Internal Medicine | 11801 S Frwy, Fort Worth, TX 76115 | 2009-02-19 |
| 1639378292 | Jeffrey J. Raymond | Physician Assistant | 544 West Seminary Dr, Fort Worth, TX 76115 | 2007-07-13 |
| 1336367952 | Luis Sierra-nieves | Physician Assistant | 544 West Seminary Drive, Fort Worth, TX 76115 | 2007-04-20 |
| 1396861209 | Remedios R Cabansag | Obstetrics & Gynecology | 11803 So Freewax, Suite 254, Fort Worth, TX 76115 | 2007-03-22 |
| 1073602611 | Courage Rehab Clinic | Clinic/Center | 1670 North Hampton Road, Suite 110, Desoto, TX 76115 | 2006-10-12 |
| 1548369200 | Vijay Khanna | Podiatrist | 4759 B South Freeway, Ft Worth, TX 76115 | 2006-09-21 |
| 1225045164 | Allan M Wallace | Optometrist | 11803 South Frwy, Suite 114, Fort Worth, TX 76115 | 2006-08-02 |
| Find all providers in zip 76115 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386255453 | Anita Lynne Fulmer | Counselor | 6270 Salem Cir Apt 120, Fort Worth, TX 76132-3003 | 2020-08-12 |
| 1215551031 | Leah Klyce Cothran | Counselor | 4200 S Hulen St Ste 674, Fort Worth, TX 76109-4987 | 2020-06-08 |
| 1194284885 | Sandra Wenclasky | Counselor | 3604 Winifred Dr, Fort Worth, TX 76133-2127 | 2019-03-13 |
| 1285113746 | Deirdre P Browne | Counselor | 1500 E El Paso, Fort Worth, TX 76102 | 2018-08-07 |
| 1306333562 | Joel Campos | Counselor | 4200 South Fwy Ste 210, Fort Worth, TX 76115-1400 | 2018-04-13 |
| 1750899225 | Jason King | Counselor | 9705 Polk Ave, Fort Worth, TX 76177-7379 | 2018-01-17 |
| 1598274771 | Donna Mcdonald Stout | Counselor | 3001a W 5th St, Fort Worth, TX 76107-2206 | 2017-09-20 |
| 1053831016 | Emily Rana Hanson | Counselor | 1801 N Riverside Dr, Fort Worth, TX 76111-2732 | 2017-06-21 |
| 1780125369 | Nichole Carter | Counselor | 4820 Valley Springs Trl, Fort Worth, TX 76244-5904 | 2017-03-15 |
| 1285181727 | Fort Wellness, Pllc | Counselor | 1809 Ridgmar Blvd, Fort Worth, TX 76116-2018 | 2016-09-01 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76115 |
Please comment or provide details below to improve the information on MRS. MERRILL L LITTLEBERRY.
| 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.