Active NPI
John Russell McLen, MMFY
- Marriage & Family Therapist
- Abilene, TX
National Provider Identifier
1487725107
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 1684
- Practice address
- 1166 N 3Rd St
Abilene, TX 79601-5831 - Phone
- (325) 676-8963
- Fax
- (325) 676-2915
- NPI assigned
- Nov 13, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 1684 | TX | Primary |
Addresses
Primary practice location
1166 N 3Rd St
Abilene, TX 79601-5831
Mailing address
1166 N 3Rd St
Abilene, TX 79601-5831
Phone (325) 676-8963
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 173B | Other | TX | BLUE CROSS |
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 |
|---|---|---|---|
| 1684 | TX | MD | Kinesiotherapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1487725107",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1166 N 3RD ST",
"city": "ABILENE",
"state": "TX",
"postal_code": "796015831",
"telephone_number": "325-676-8963",
"fax_number": "325-676-2915"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1166 N 3RD ST",
"city": "ABILENE",
"state": "TX",
"postal_code": "796015831",
"telephone_number": "325-676-8963",
"fax_number": "325-676-2915"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCLEN",
"first_name": "JOHN",
"middle_name": "RUSSELL",
"name_prefix": "Mr.",
"credential": "MMFY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "TX",
"license": "1684",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "173B",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Abilene, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.