Organization Active NPI

Banner Counseling & Wellness PLLC

  • Professional Counselor
  • Tyler, TX
National Provider Identifier
1083599716
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
BANNER COUNSELING & WELLNESS PLLC
Practice address
2269 W Cumberland Rd Ste 202
Tyler, TX 75703-5481
Phone
(903) 714-7205
NPI assigned
Aug 11, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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

Authorized official

Name
Lauren Peacock, MA, LPCNPI 1669088134
Title
Therapist, Owner
Phone
(903) 714-7205

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
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

2269 W Cumberland Rd Ste 202
Tyler, TX 75703-5481

Mailing address

2269 W Cumberland Rd Ste 202
Tyler, TX 75703-5481
Phone (903) 714-7205

National Provider Directory

National Provider Directory

Locations

2269 W Cumberland Rd
Ste 202
Tyler, TX 75703
Phone (903) 714-7205

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": "1754870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754870400000",
    "number": "1083599716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2269 W CUMBERLAND RD STE 202",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757035481",
            "telephone_number": "903-714-7205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2269 W CUMBERLAND RD STE 202",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757035481",
            "telephone_number": "903-714-7205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANNER COUNSELING & WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-11",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A",
        "authorized_official_last_name": "PEACOCK",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_title_or_position": "THERAPIST, OWNER",
        "authorized_official_telephone_number": "903-714-7205",
        "authorized_official_credential": "MA, LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "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 Aug 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.