Active NPI
Laramie C Selman, LPC
- Mental Health Counselor
- Tyler, TX
National Provider Identifier
1003183914
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 61409
- Practice address
- 4101 University Blvd
Tyler, TX 75701-6623 - Phone
- (903) 363-7704
- NPI assigned
- Nov 20, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 61409 | TX | Primary |
| Mental Health Counselor | 101YM0800X | 32049 | TX |
Addresses
Primary practice location
4101 University Blvd
Tyler, TX 75701-6623
Mailing address
PO Box 883
Frankston, TX 75763-0883
Phone (903) 363-7704
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61409 | TX | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1321747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321747200000",
"number": "1003183914",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 883",
"city": "FRANKSTON",
"state": "TX",
"postal_code": "757630883",
"telephone_number": "903-363-7704"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4101 UNIVERSITY BLVD",
"city": "TYLER",
"state": "TX",
"postal_code": "757016623",
"telephone_number": "903-363-7704"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SELMAN",
"first_name": "LARAMIE",
"middle_name": "C",
"name_prefix": "Mr.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-11-20",
"last_updated": "2011-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "61409",
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "32049",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tyler, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.