Purple Crayon Counseling, PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

PURPLE CRAYON COUNSELING, PLLC

Practice address

401 E Front St Ste 227
Tyler, TX 75702-8219

Phone

(903) 287-0646

Fax

(903) 560-9500

NPI assigned

Mar 23, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Nelida Medina, LCSW

Title

Owner/Clinician

Phone

(903) 287-0646

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1616457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616457600000",
    "number": "1003492570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10845 COUNTY ROAD 429",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757043813",
            "telephone_number": "903-714-4991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E FRONT ST STE 227",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757028219",
            "telephone_number": "903-287-0646",
            "fax_number": "903-560-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURPLE CRAYON COUNSELING, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-23",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A",
        "authorized_official_last_name": "MEDINA",
        "authorized_official_first_name": "NELIDA",
        "authorized_official_title_or_position": "OWNER/CLINICIAN",
        "authorized_official_telephone_number": "903-287-0646",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "405322501",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nelida@purplecrayoncounseling.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "401 E Front St Ste 227",
            "city": "Tyler",
            "state": "TX",
            "country_code": "US",
            "postal_code": "757028219",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Clinical Social Worker in Tyler, TX
• Providers in Tyler, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.