Active NPI
Teirney Medeiros, LPC
- Mental Health Counselor
- Gatesville, TX
National Provider Identifier
1427448166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 77929
- Practice address
- 1401 Old State School Road
Gatesville, TX 76599-4612 - Phone
- (254) 654-1796
- NPI assigned
- Feb 3, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 77929 | TX | Primary |
Addresses
Primary practice location
1401 Old State School Road
Gatesville, TX 76599-4612
Mailing address
417 Racetrack Rd NW
Fort Walton Beach, FL 32547-4612
Phone (850) 864-2273
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 77929 | TX | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1422921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585699200000",
"number": "1427448166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "417 RACETRACK RD NW",
"city": "FORT WALTON BEACH",
"state": "FL",
"postal_code": "325474612",
"telephone_number": "850-864-2273",
"fax_number": "850-862-6270"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 OLD STATE SCHOOL ROAD",
"city": "GATESVILLE",
"state": "TX",
"postal_code": "765994612",
"telephone_number": "254-654-1796"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDEIROS",
"first_name": "TEIRNEY",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-02-03",
"last_updated": "2020-04-01",
"certification_date": "2020-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "77929",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gatesville, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.