Michael'S House of Hope

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Legal business name

MICHAEL'S HOUSE OF HOPE

Practice address

18535 Hwy 69 S
Tyler, TX 75703-8004

Phone

(903) 871-8700

Fax

(903) 871-8880

NPI assigned

Dec 17, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Marcus Levinsky Wade, LCDC

Title

Director of Outreach

Phone

(903) 871-8700

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1229472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229472000000",
    "number": "1295971588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18535 HWY 69 S",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757038004",
            "telephone_number": "903-871-8700",
            "fax_number": "903-871-8880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18535 HWY 69 S",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757038004",
            "telephone_number": "903-871-8700",
            "fax_number": "903-871-8880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL'S HOUSE OF HOPE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-17",
        "last_updated": "2008-12-17",
        "status": "A",
        "authorized_official_last_name": "WADE",
        "authorized_official_first_name": "MARCUS",
        "authorized_official_middle_name": "LEVINSKY",
        "authorized_official_title_or_position": "DIRECTOR OF OUTREACH",
        "authorized_official_telephone_number": "903-871-8700",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCDC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in Tyler, TX
• Providers in Tyler, TX by specialty
• Addiction (Substance Use Disorder) Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 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.

Verify at the official NPI Registry.