Individual provider Active NPI

Mayra Trejo, LPC

  • Mental Health Counselor
  • Longview, TX
National Provider Identifier
1295566073
Registry record updated Apr 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
89340 Issued in TX
Practice address
213 N Fredonia St Ste 280
Longview, TX 75601-7286
Phone
(903) 472-0505
NPI assigned
Aug 12, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 89340 TX
Professional Counselor 101YP2500X 89340 TX
Mental Health Counselor 101YM0800X 89340 TX Primary

Addresses

Primary practice location

213 N Fredonia St Ste 280
Longview, TX 75601-7286

Mailing address

213 N Fredonia St Ste 280
Longview, TX 75601-7286
Phone (903) 472-0505

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
I20251205003597 TX Practitioner - Mental Health Counselor 7315438397 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1121 Judson Rd
Suite 140
Longview, TX 75601-5119

1121 Judson Rd
Suite 140
Longview, TX 75601-5199

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
89340TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Sanamente Aliados Professional CurrentSince Oct 4, 2024 Accepting new patients

Locations

2019B S Henderson Blvd
Ste 15
Kilgore, TX 75662
Phone (903) 309-0702

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": "1723420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1295566073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 N FREDONIA ST STE 280",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756017286",
            "telephone_number": "903-472-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 N FREDONIA ST STE 280",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756017286",
            "telephone_number": "903-472-0505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREJO",
        "first_name": "MAYRA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-12",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TX",
            "license": "89340",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "89340",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "89340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

Verify at the official NPI Registry.