Provider Demographics
NPI:1396765103
Name:VORKOPER, CHARLES F (LCSW, LPC, LMFT)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:F
Last Name:VORKOPER
Suffix:
Gender:M
Credentials:LCSW, LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5710 LYNDON B JOHNSON FWY
Mailing Address - Street 2:SUITE 210
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-6324
Mailing Address - Country:US
Mailing Address - Phone:972-490-1007
Mailing Address - Fax:972-490-9337
Practice Address - Street 1:5710 LYNDON B JOHNSON FWY
Practice Address - Street 2:SUITE 210
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-6324
Practice Address - Country:US
Practice Address - Phone:972-490-1007
Practice Address - Fax:972-490-9337
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS00702101YP2500X
TX001704101YP2500X
TX000861101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXR69151Medicare UPIN