Individual provider Active NPI

Marcus Tanner, PH.D., LMFT-S

  • Marriage & Family Therapist
  • Lubbock, TX
National Provider Identifier
1558785287
Registry record updated Apr 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
202235 Issued in TX
Practice address
7021 Kewanee Ave BLDG 10
Lubbock, TX 79424-7048
Phone
(806) 319-7400
NPI assigned
Feb 17, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 202235 TX Primary

Addresses

Primary practice location

7021 Kewanee Ave BLDG 10
Lubbock, TX 79424-7048

Mailing address

5717 66TH St Ste 209
Lubbock, TX 79424-1593
Phone (806) 319-7400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 4, 2024 through Jan 4, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
202235TXMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Healingchoice Family Therapy, PLLC Marriage & Family Therapist CurrentSince Aug 28, 2021 Accepting new patients

Locations

5717 66th St
Ste 131
Lubbock, TX 79424
Phone (806) 319-7400

7021 Kewanee Ave
Bldg 10
Lubbock, TX 79424
Phone (806) 319-7400

5717 66th St
Ste 209
Lubbock, TX 79424
Phone (806) 319-7400

7021 Kewanee Ave
Ste 10
Lubbock, TX 79424

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1392595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711929600000",
    "number": "1558785287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5717 66TH ST STE 209",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794241593",
            "telephone_number": "806-319-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7021 KEWANEE AVE BLDG 10",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794247048",
            "telephone_number": "806-319-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNER",
        "first_name": "MARCUS",
        "name_prefix": "Dr.",
        "credential": "PH.D., LMFT-S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-17",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "202235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.