Active NPI
Wayne D Welch, LPC (LICENSED PROFES
- Professional Counselor
- Tyler, TX
National Provider Identifier
1245480490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 02766
- Practice address
- 3800 Paluxy Dr Suite 440
Tyler, TX 75703-1659 - Phone
- (903) 526-5550
- Fax
- (903) 526-5551
- NPI assigned
- Sep 24, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 02766 | TX | Primary |
Addresses
Primary practice location
3800 Paluxy Dr Suite 440
Tyler, TX 75703-1659
Mailing address
3800 Paluxy Dr Suite 440
Tyler, TX 75703-1659
Phone (903) 526-5550
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 |
|---|---|---|---|
| 02766 | TX | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Charles T Fries Edd PC | Professional | Past | Accepting new patients |
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": "1222214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1222214400000",
"number": "1245480490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3800 PALUXY DR SUITE 440",
"city": "TYLER",
"state": "TX",
"postal_code": "757031659",
"telephone_number": "903-526-5550",
"fax_number": "903-526-5551"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3800 PALUXY DR SUITE 440",
"city": "TYLER",
"state": "TX",
"postal_code": "757031659",
"telephone_number": "903-526-5550",
"fax_number": "903-526-5551"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELCH",
"first_name": "WAYNE",
"middle_name": "D",
"name_prefix": "Mr.",
"credential": "LPC (LICENSED PROFES",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-09-24",
"last_updated": "2008-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "02766",
"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 Sep 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.