Provider Demographics
NPI:1831932854
Name:ESTRADA, NANCY (MS, LPC-A, NCC)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:ESTRADA
Suffix:
Gender:F
Credentials:MS, LPC-A, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3509 HULEN ST STE 107
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76107-6834
Mailing Address - Country:US
Mailing Address - Phone:817-296-7174
Mailing Address - Fax:
Practice Address - Street 1:3509 HULEN ST STE 107
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107-6834
Practice Address - Country:US
Practice Address - Phone:817-296-7174
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX91191101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health