Provider Demographics
NPI:1427769348
Name:SW FW MENTAL HEALTH , PLLC
Entity type:Organization
Organization Name:SW FW MENTAL HEALTH , PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:214-842-9581
Mailing Address - Street 1:103 WILSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:EULESS
Mailing Address - State:TX
Mailing Address - Zip Code:76040-4101
Mailing Address - Country:US
Mailing Address - Phone:214-842-9581
Mailing Address - Fax:
Practice Address - Street 1:6628 BRYANT IRVIN RD STE 200
Practice Address - Street 2:
Practice Address - City:FT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76132-4221
Practice Address - Country:US
Practice Address - Phone:214-842-9581
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ELLIE FAMILY SERVICES, PLLP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-12-12
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)