Individual provider Active NPI

Cindy Hernandez-Real, LCDC

  • Addiction (Substance Use Disorder) Counselor
  • Tyler, TX
National Provider Identifier
1487995155
Registry record updated Mar 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
104 Jordan Plaza Blvd
Suite 402 & 403
Tyler, TX 75704-2055
Phone
(903) 581-9472
Fax
(903) 234-0862
NPI assigned
Mar 6, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X TX Primary

Addresses

Primary practice location

104 Jordan Plaza Blvd
Suite 402 & 403
Tyler, TX 75704-2055

Mailing address

PO Box 6800
Longview, TX 75608-6800
Phone (903) 758-2471

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

NPI Registry JSON

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

{
    "created_epoch": "1362528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362528000000",
    "number": "1487995155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6800",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756086800",
            "telephone_number": "903-758-2471",
            "fax_number": "903-234-0862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 JORDAN PLAZA BLVD",
            "address_2": "SUITE 402 & 403",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757042055",
            "telephone_number": "903-581-9472",
            "fax_number": "903-234-0862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ-REAL",
        "first_name": "CINDY",
        "name_prefix": "Mrs.",
        "credential": "LCDC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-06",
        "last_updated": "2013-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2013; 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.