Individual provider Active NPI

Jennifer Elaine Brashear, L.P.C.

  • Counselor
  • Tyler, TX
National Provider Identifier
1306995386
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
18371 Issued in TX
Practice address
2323 W Front St
Tyler, TX 75702-7747
Phone
(903) 597-1351
NPI assigned
Jan 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 8643 TX
Mental Health Counselor 101YM0800X
Counselor 101Y00000X 18371 TX Primary

Addresses

Primary practice location

2323 W Front St
Tyler, TX 75702-7747

Mailing address

PO Box 4730
Tyler, TX 75712-4730
Phone (035) 971-3519

Other identifiers 1

IdentifierTypeStateIssuer
081844501MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8643TXMDAddiction (Substance Use Disorder) Counselor
18371TXMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1306995386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4730",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757124730",
            "telephone_number": "035-971-3519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2323 W FRONT ST",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757027747",
            "telephone_number": "903-597-1351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRASHEAR",
        "first_name": "JENNIFER",
        "middle_name": "ELAINE",
        "credential": "L.P.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-09",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "8643",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TX",
            "license": "18371",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "081844501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.