NPIMap

Organization Active NPI

Paideia Counseling LLC

  • Community/Behavioral Health Agency
  • Tyler, TX
National Provider Identifier
1043959943
Registry record updated May 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
PAIDEIA COUNSELING LLC
Practice address
3815 Pine Manor Dr
Tyler, TX 75701-6736
Phone
(907) 885-5955
NPI assigned
May 31, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2022

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

Authorized official

Name
Dr. Deborah Grace Bannan, PHDNPI 1437524204
Title
Owner
Phone
(907) 885-5955

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

3815 Pine Manor Dr
Tyler, TX 75701-6736

Mailing address

3815 Pine Manor Dr
Tyler, TX 75701-6736
Phone (907) 885-5955

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1653955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653955200000",
    "number": "1043959943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3815 PINE MANOR DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757016736",
            "telephone_number": "907-885-5955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3815 PINE MANOR DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757016736",
            "telephone_number": "907-885-5955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIDEIA COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-31",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A",
        "authorized_official_last_name": "BANNAN",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "GRACE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "907-885-5955",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "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 May 31, 2022; 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.