Provider Demographics
NPI:1073230439
Name:INKED COUNSELING CENTER PLLC
Entity type:Organization
Organization Name:INKED COUNSELING CENTER PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:
Authorized Official - Last Name:WOOLDRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-S
Authorized Official - Phone:817-791-8410
Mailing Address - Street 1:3410 BASSWOOD BLVD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76137-0000
Mailing Address - Country:US
Mailing Address - Phone:817-791-8410
Mailing Address - Fax:
Practice Address - Street 1:3410 BASSWOOD BLVD
Practice Address - Street 2:SUITE 120
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76137-0000
Practice Address - Country:US
Practice Address - Phone:817-791-8410
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-25
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty