Individual provider Active NPI

Lynn Rutherford, LPC

  • Professional Counselor
  • Freeport, TX
National Provider Identifier
1174646707
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
13307 Issued in TX
Practice address
5310 Brazos River Rd
Freeport, TX 77541-8244
Phone
(512) 289-0922
NPI assigned
Apr 9, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 13307 TX Primary

Addresses

Primary practice location

5310 Brazos River Rd
Freeport, TX 77541-8244

Mailing address

5310 Brazos River Rd
Freeport, TX 77541-8244
Phone (512) 289-0922

Other identifiers 1

IdentifierTypeStateIssuer
0277980-01MedicaidTX

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
I20250411000954 TX Practitioner - Mental Health Counselor 7911421995 Practice locations: Freeport, TX

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

5310 Brazos River Rd
Freeport, TX 77541-8244
Phone (512) 289-0922

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1174646707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5310 BRAZOS RIVER RD",
            "city": "FREEPORT",
            "state": "TX",
            "postal_code": "775418244",
            "telephone_number": "512-289-0922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5310 BRAZOS RIVER RD",
            "city": "FREEPORT",
            "state": "TX",
            "postal_code": "775418244",
            "telephone_number": "512-289-0922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTHERFORD",
        "first_name": "LYNN",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-09",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "13307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0277980-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Freeport, TX

Sources for this page

Verify at the official NPI Registry.