Individual provider Active NPI

Erin Cameron, LPC

  • Professional Counselor
  • Tyler, TX
National Provider Identifier
1124642798
Registry record updated Oct 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
78744 Issued in TX
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

Updated by the provider on Oct 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
78744TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Legendary Counseling, PLLC Addiction (Substance Use Disorder) CurrentSince Oct 1, 2020 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.

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.

Verify at the official NPI Registry.