Tinalee Puawehiwa De Costa, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

77917 Issued in TX

Practice address

3816 Clear Creek Rd Ste C301
Killeen, TX 76549-4107

Phone

(254) 773-4022

Fax

(254) 773-0919

NPI assigned

Jan 5, 2021

Last updated

Jan 5, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Progressive Behavioral Health, PLLC

  dba LifeStance Health

  • Mental Health Counselor
  • Friendswood, TX
  • NPI 1659567238

  Professional

  NPD
• Chupik Counseling & Consulting PA

  • Specialist
  • Temple, TX
  • NPI 1548551021
  NPD (past)

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

{
    "created_epoch": "1609804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609804800000",
    "number": "1437747540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1108",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765031108",
            "telephone_number": "254-773-4022",
            "fax_number": "254-773-0919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3816 CLEAR CREEK RD STE C301",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765494107",
            "telephone_number": "254-773-4022",
            "fax_number": "254-773-0919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE COSTA",
        "first_name": "TINALEE",
        "middle_name": "PUAWEHIWA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-05",
        "last_updated": "2021-01-05",
        "certification_date": "2021-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "77917",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF TEXAS",
            "identifier": "77917",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charles R Day, M.D.
• Phillip L Day, MD
• Dazona Life and Learning Center
• DCS Medical PA
• Dcstudio LLC
• Suleika Marie De Gracia Rivera, LPC
• Isabel De la Cruz
• John Doran Deapen, O.D.
• Da Shanda Deas-Davis, LPC
• Debbie Mabray PLLC (Counseling Solutions)

• Professional Counselor in Killeen, TX
• Providers in Killeen, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2021; 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.