Individual provider Active NPI

Jennifer Ann Piazza, M.S.

  • Professional Counselor
  • Tyler, TX
National Provider Identifier
1124467964
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
67330 Issued in TX
Practice address
7925 S Broadway Ave Ste 920
Tyler, TX 75703-5227
Phone
(903) 251-9650
NPI assigned
Jun 14, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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 67330 TX Primary
Mental Health Counselor 101YM0800X 67330 TX

Addresses

Primary practice location

7925 S Broadway Ave Ste 920
Tyler, TX 75703-5227

Mailing address

7925 S Broadway Ave Ste 920
Tyler, TX 75703-5227
Phone (903) 251-9650

Other identifiers 1

IdentifierTypeStateIssuer
67330OtherTXTEXAS STATE BOARD OF EXAMINERS OF PROFESSIONAL COUNSELORS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240607000959 TX Practitioner - Mental Health Counselor 7416499264 Practice locations: Tyler, TX

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1800 Shiloh Rd
Suite 200
Tyler, TX 75703-2418

7925 S Broadway Ave
Suite 920
Tyler, TX 75703-5286
Phone (903) 251-9650

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
67330TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Chelsea Harper Counseling, LLC CurrentSince Nov 24, 2024 Accepting new patients
Mind and Motion PLLC Professional CurrentSince Apr 25, 2024 Accepting new patients
Tyler Counseling & Assessment Center Professional PastSince Sep 22, 1999 Accepting new patients
Ron L. Roberts, M.S., P.C. Professional PastSince Oct 1, 2019 Accepting new patients

Locations

7925 S Broadway Ave
Ste 920
Tyler, TX 75703
Phone (903) 251-9650

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1371168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1124467964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7925 S BROADWAY AVE STE 920",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757035227",
            "telephone_number": "903-251-9650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7925 S BROADWAY AVE STE 920",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757035227",
            "telephone_number": "903-251-9650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIAZZA",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-14",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "67330",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "67330",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS STATE BOARD OF EXAMINERS OF PROFESSIONAL COUNSELORS",
            "identifier": "67330",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.