Provider Demographics
NPI:1023112521
Name:BARRA, DOROTHY MARIE (LPC)
Entity type:Individual
Prefix:MS
First Name:DOROTHY
Middle Name:MARIE
Last Name:BARRA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MRS
Other - First Name:DOROTHY
Other - Middle Name:M
Other - Last Name:HECHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3408 COCKRELL AVE
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76109-3003
Mailing Address - Country:US
Mailing Address - Phone:817-924-6650
Mailing Address - Fax:817-922-0398
Practice Address - Street 1:2501 FOREST PARK BLVD STE 3B
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76110-2257
Practice Address - Country:US
Practice Address - Phone:817-924-6650
Practice Address - Fax:817-922-0398
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13162101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX140787602Medicaid