Individual provider Active NPI

Misti Dawn Wetzel, LMFT

  • Marriage & Family Therapist
  • Temple, TX
National Provider Identifier
1346512142
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
201818 Issued in TX
Practice address
2027 S 61St St Ste 112
Temple, TX 76504-6857
Phone
(254) 563-9228
Fax
(855) 971-0138
NPI assigned
Feb 8, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 201818 TX
Marriage & Family Therapist 106H00000X 201818 TX Primary

Addresses

Primary practice location

2027 S 61St St Ste 112
Temple, TX 76504-6857

Mailing address

2027 S 61St St Ste 112
Temple, TX 76504-6857
Phone (254) 563-9228

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
I20240522000158 TX Practitioner - Mental Health Counselor 3779934088 Practice locations: Temple, TX

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2027 S 61St St
Suite 112
Temple, TX 76504-6857
Phone (254) 563-9228

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
201818TXMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1328659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1346512142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2027 S 61ST ST STE 112",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765046857",
            "telephone_number": "254-563-9228",
            "fax_number": "855-971-0138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2027 S 61ST ST STE 112",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765046857",
            "telephone_number": "254-563-9228",
            "fax_number": "855-971-0138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WETZEL",
        "first_name": "MISTI",
        "middle_name": "DAWN",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-08",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "201818",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "201818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple, TX

Sources for this page

Verify at the official NPI Registry.