Provider Demographics
NPI:1992441646
Name:GARRISON, ELAINE F (MS, LPC)
Entity type:Individual
Prefix:MRS
First Name:ELAINE
Middle Name:F
Last Name:GARRISON
Suffix:
Gender:M
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6717 MEADOWS WEST DR S
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76132-1103
Mailing Address - Country:US
Mailing Address - Phone:817-996-8995
Mailing Address - Fax:
Practice Address - Street 1:550 BAILEY AVE STE 235
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107-2100
Practice Address - Country:US
Practice Address - Phone:817-304-7549
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-06
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX69635101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional