P.E.E.R. Pals, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

68632 Issued in TX

Legal business name

P.E.E.R. PALS, LLC

Practice address

200 W 2ND St
228-A
Freeport, TX 77541-5773

Phone

(713) 724-3603

NPI assigned

Oct 5, 2016

Organization subpart

Yes

Parent organization

P.E.E.R. PALS, LLCAs reported in NPPES

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

Authorized official

Name

Mrs. Travett Robinson Johnson, LPC

Title

Owner

Phone

(713) 724-3603

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

Peer Pals LLC

Locations

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

{
    "created_epoch": "1475625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475625600000",
    "number": "1447700166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W 2ND ST",
            "address_2": "228-A",
            "city": "FREEPORT",
            "state": "TX",
            "postal_code": "775415773",
            "telephone_number": "713-724-3603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W 2ND ST",
            "address_2": "228-A",
            "city": "FREEPORT",
            "state": "TX",
            "postal_code": "775415773",
            "telephone_number": "713-724-3603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "P.E.E.R. PALS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "P.E.E.R. PALS, LLC",
        "enumeration_date": "2016-10-05",
        "last_updated": "2016-10-05",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "TRAVETT",
        "authorized_official_middle_name": "ROBINSON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "713-724-3603",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "TX",
            "license": "68632",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "325808902",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2016; 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.