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Michael Fortune
Addiction (Substance Use Disorder) Counselor in Liberty, Texas
NPI 1104298280

Michael Fortune is an Addiction (Substance Use Disorder) Counselor based in Liberty, TX and is specialized in Addiction (Substance Use Disorder). Michael Fortune practices in Liberty, TX. The NPI Number for Michael Fortune is 1104298280 and holds a License No. 12037 (Texas).

The current practice location address for Michael Fortune is 2800 Beaumont Ave # 1, Liberty, TX and can be reached out via phone at 936-253-1077.

Location: 2800 Beaumont Ave # 1, Liberty, TX, 77575-5126
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1104298280
Provider Name
Michael Fortune
Credential
Provider Entity Type
Individual
Gender
Female
Address
2800 Beaumont Ave # 1, Liberty, TX, 77575-5126
Phone Number
936-253-1077
Fax Number
Provider Enumeration Date
10/28/2015
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
12037 01 TX LICENSE
institution
Provider Business Practice Location Address Details
Address
2800 Beaumont Ave # 1
City
Liberty
State
Texas
Zip
77575-5126
Phone Number
936-253-1077
Fax Number
person
Provider Business Mailing Address Details
Address
2800 Beaumont Ave # 1
City
Liberty
State
Texas
Zip
77575-5126
Phone Number
936-253-1077
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
12037 (Texas)
Definition
Definition to come...
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