Organization Active NPI

Mud Lotus & Fire Psychotherapy PLLC

  • Professional Counselor
  • Dallas, TX
National Provider Identifier
1396641940
Registry record updated Oct 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
MUD LOTUS & FIRE PSYCHOTHERAPY PLLC
Practice address
3900 Briargrove LN Apt 14310
Dallas, TX 75287-8336
Phone
(469) 305-2433
Fax
(432) 201-4619
NPI assigned
Oct 19, 2026
Last updated
Oct 19, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2026

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

Authorized official

Name
Tyler Ray Pruitt, LPC
Title
Licensed Professional Counselor
Phone
(469) 305-2433

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X Primary

Addresses

Primary practice location

3900 Briargrove LN Apt 14310
Dallas, TX 75287-8336

Mailing address

3900 Briargrove LN Apt 14310
Dallas, TX 75287-8336
Phone (469) 305-2433

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1792368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1792368000000",
    "number": "1396641940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 BRIARGROVE LN APT 14310",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752878336",
            "telephone_number": "469-305-2433",
            "fax_number": "432-201-4619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 BRIARGROVE LN APT 14310",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752878336",
            "telephone_number": "469-305-2433",
            "fax_number": "432-201-4619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUD LOTUS & FIRE PSYCHOTHERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-10-19",
        "last_updated": "2026-10-19",
        "certification_date": "2026-10-19",
        "status": "A",
        "authorized_official_last_name": "PRUITT",
        "authorized_official_first_name": "TYLER",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "LICENSED PROFESSIONAL COUNSELOR",
        "authorized_official_telephone_number": "469-305-2433",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2026; 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.