Individual provider Active NPI

Bryan Mitchell Elliott, LPC, LMFT

  • Marriage & Family Therapist
  • San Angelo, TX
National Provider Identifier
1033126644
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
004794-041978 Issued in TX
Practice address
2200 Johnson Ave
San Angelo, TX 76904-5441
Phone
(325) 949-3701
Fax
(325) 947-3585
NPI assigned
Aug 3, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 14593 TX
Marriage & Family Therapist 106H00000X 004794-041978 TX Primary

Addresses

Primary practice location

2200 Johnson Ave
San Angelo, TX 76904-5441

Mailing address

2200 Johnson Ave
San Angelo, TX 76904-5441
Phone (325) 949-3701

Other identifiers 1

IdentifierTypeStateIssuer
3619LCOtherTXBLUE CROSS BLUE SHIELD

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

LicenseStateTypeSpecialty
004794-041978TXMDMarriage & Family Therapist
14593TXMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1033126644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 JOHNSON AVE",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769045441",
            "telephone_number": "325-949-3701",
            "fax_number": "325-947-3585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 JOHNSON AVE",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769045441",
            "telephone_number": "325-949-3701",
            "fax_number": "325-947-3585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "BRYAN",
        "middle_name": "MITCHELL",
        "name_prefix": "Mr.",
        "credential": "LPC, LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "14593",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "004794-041978",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "3619LC",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Angelo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.