Active NPI
Kimberly Tanuvasa, LPC
- Mental Health Counselor
- Frisco, TX
National Provider Identifier
1104187244
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 64907
- Practice address
- 9555 Lebanon Rd Ste 402
Frisco, TX 75035-6082 - Phone
- (469) 777-3050
- Fax
- (469) 777-3454
- NPI assigned
- Jun 5, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 64907 | TX | Primary |
Addresses
Primary practice location
9555 Lebanon Rd Ste 402
Frisco, TX 75035-6082
Mailing address
1601 Idyllwild CT
Plano, TX 75075-2124
Phone (214) 457-8686
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 |
|---|---|---|---|
| 64907 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Assis Counseling PLLC | Mental Health | Past | Accepting new patients |
| Galaxy Counseling Center | Past | Accepting new patients | |
| Galaxy Counseling Center | Mental Health | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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- NPI 1184854945
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- Mental Health Counselor
- Garland, TX
- NPI 1730249368
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1338854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649116800000",
"number": "1104187244",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1601 IDYLLWILD CT",
"city": "PLANO",
"state": "TX",
"postal_code": "750752124",
"telephone_number": "214-457-8686",
"fax_number": "888-688-1534"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9555 LEBANON RD STE 402",
"city": "FRISCO",
"state": "TX",
"postal_code": "750356082",
"telephone_number": "469-777-3050",
"fax_number": "469-777-3454"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TANUVASA",
"first_name": "KIMBERLY",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-06-05",
"last_updated": "2022-04-05",
"certification_date": "2022-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "64907",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Frisco, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 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.