Nancy Blum, LPC
Individual provider Active NPI Professional Counselor · Terrell, TX
NPI 1104243179 · NPPES record last updated Mar 27, 2014
Key facts
- NPI
- 1104243179
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 63176 (TX)
- Practice address
- 400 Airport Rd
Terrell, TX 75160-4302 - Phone
- (972) 524-4159
- Fax
- (972) 563-4433
- NPI assigned
- Mar 27, 2014
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250508001140 | UT | Practitioner - Mental Health Counselor | 4789021098 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 63176 | TX | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Collaborative Counseling | Professional | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 63176 | TX | Yes |
Addresses
Primary practice location
400 Airport Rd
Terrell, TX 75160-4302
Mailing address
PO Box 747
Terrell, TX 75160-0014
Phone (972) 524-4159
Other providers in Terrell, TX
- Martha B Bibler
- Bio-Medical Applications of Texas, Inc.
- Rashmi Bisen
- James A Blair
- Blessed Joy Midwifery
- Lisa Marie Bonilla
- Michele F. Bowerman
- Mandy De Ann Boyce
- O'Delia Bradshaw
- Bright Smile Dental Clinic
All providers in Terrell, TX · Professional Counselor in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 27, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.