Active NPI
Erin Cameron, LPC
- Professional Counselor
- Tyler, TX
National Provider Identifier
1124642798
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 78744
- Practice address
- 7925 S Broadway Ave Ste 440
Tyler, TX 75703-5297 - Phone
- (903) 705-6337
- Fax
- (903) 705-6532
- NPI assigned
- May 29, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Professional Counselor | 101YP2500X | 78744 | TX | Primary |
Addresses
Primary practice location
7925 S Broadway Ave Ste 440
Tyler, TX 75703-5297
Mailing address
7925 S Broadway Ave Ste 440
Tyler, TX 75703-5297
Phone (903) 705-6337
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 |
|---|---|---|---|
| 78744 | TX | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Legendary Counseling, PLLC | Addiction (Substance Use Disorder) | Current | Accepting new patients |
Locations
7925 S Broadway Ave
Ste 440
Tyler, TX 75703
Phone (903) 705-6337
120 W 5th St
Ste 105
Tyler, TX 75701
Phone (903) 201-7865
Organizations & group practices 1
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.
-
- Mental Health Counselor
- Tyler, TX
- NPI 1356953046
Addiction (Substance Use Disorder)
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1590710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698451200000",
"number": "1124642798",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7925 S BROADWAY AVE STE 440",
"city": "TYLER",
"state": "TX",
"postal_code": "757035297",
"telephone_number": "903-705-6337",
"fax_number": "903-705-6532"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7925 S BROADWAY AVE STE 440",
"city": "TYLER",
"state": "TX",
"postal_code": "757035297",
"telephone_number": "903-705-6337",
"fax_number": "903-705-6532"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMERON",
"first_name": "ERIN",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-29",
"last_updated": "2023-10-28",
"certification_date": "2023-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "78744",
"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 Oct 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.