Active NPI
David Keith Duffey, LPA, LPC
- Counseling Psychologist
- Tyler, TX
National Provider Identifier
1174011779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 1-2556
- Practice address
- 657 Prestonwood Cir
Tyler, TX 75703-5045 - Phone
- (903) 944-7295
- NPI assigned
- Apr 29, 2018
- Last updated
- Apr 29, 2018
- Sex
- Male
- Sole proprietor
- Yes
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 | 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
| License | State | Type | Specialty |
|---|---|---|---|
| 09274 | TX | MD | Mental Health Counselor |
| 1-2556 | TX | MD | Counseling 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.