Individual provider Active NPI

David Keith Duffey, LPA, LPC

  • Counseling Psychologist
  • Tyler, TX
National Provider Identifier
1174011779
Registry record updated Apr 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
1-2556 Issued in TX
Practice address
657 Prestonwood Cir
Tyler, TX 75703-5045
Phone
(903) 944-7295
NPI assigned
Apr 29, 2018
Last updated
Apr 29, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2018

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 09274 TX
Counseling Psychologist 103TC1900X 1-2556 TX Primary

Addresses

Primary practice location

657 Prestonwood Cir
Tyler, TX 75703-5045

Mailing address

657 Prestonwood Cir
Tyler, TX 75703-5045
Phone (903) 944-7295

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
09274TXMDMental Health Counselor
1-2556TXMDCounseling Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1524960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524960000000",
    "number": "1174011779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "657 PRESTONWOOD CIR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757035045",
            "telephone_number": "903-944-7295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "657 PRESTONWOOD CIR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757035045",
            "telephone_number": "903-944-7295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUFFEY",
        "first_name": "DAVID",
        "middle_name": "KEITH",
        "name_prefix": "Mr.",
        "credential": "LPA, LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-29",
        "last_updated": "2018-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "09274",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "TX",
            "license": "1-2556",
            "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 Apr 29, 2018; 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.