Active NPI
Paula Lynch Massey
- Professional Counselor
- Tyler, TX
National Provider Identifier
1275652265
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 19666
- Practice address
- 3800 Paluxy Dr Ste 440
Tyler, TX 75703-1659 - Phone
- (903) 526-5550
- NPI assigned
- Mar 29, 2007
- Sex
- Female
- 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 | 19666 | TX | Primary |
Addresses
Primary practice location
3800 Paluxy Dr Ste 440
Tyler, TX 75703-1659
Mailing address
PO Box 392
Bullard, TX 75757-0392
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1763062-02 | Medicaid | TX |
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 |
|---|---|---|---|
| 19666 | TX | MD | Speech-Language Pathologist |
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": "1175126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1229385600000",
"number": "1275652265",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 392",
"city": "BULLARD",
"state": "TX",
"postal_code": "757570392"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3800 PALUXY DR STE 440",
"city": "TYLER",
"state": "TX",
"postal_code": "757031659",
"telephone_number": "903-526-5550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASSEY",
"first_name": "PAULA",
"middle_name": "LYNCH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-29",
"last_updated": "2008-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "19666",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1763062-02",
"state": "TX"
}
],
"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 Dec 16, 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.