NPIMap

Organization Active NPI

Rebirth Inc.

  • Professional Counselor
  • Irving, TX
National Provider Identifier
1588282032
Registry record updated Jul 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
REBIRTH INC.
Practice address
612 N Story Rd Ste 101
Irving, TX 75061-6764
Phone
(469) 608-0295
Fax
(903) 913-7274
NPI assigned
Jul 10, 2020
Last updated
Jul 10, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2020

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

Authorized official

Name
Ms. Crystal Dionne Dudley, LPCNPI 1477050284
Title
Owner
Phone
(469) 608-0295

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X NU Primary

Addresses

Primary practice location

612 N Story Rd Ste 101
Irving, TX 75061-6764

Mailing address

PO Box 3113
Kilgore, TX 75663-3113

National Provider Directory

National Provider Directory
Tax ID family
Rebirth Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

  • Rebirth Inc.

    dba Rebirth Wellness

    • Substance Abuse Rehabilitation Facility
    • Carrollton, TX
    • NPI 1285482075
    NPD tax ID

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1594339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594339200000",
    "number": "1588282032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3113",
            "city": "KILGORE",
            "state": "TX",
            "postal_code": "756633113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 N STORY RD STE 101",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750616764",
            "telephone_number": "469-608-0295",
            "fax_number": "903-913-7274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REBIRTH INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-10",
        "last_updated": "2020-07-10",
        "certification_date": "2020-07-10",
        "status": "A",
        "authorized_official_last_name": "DUDLEY",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_middle_name": "DIONNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "469-608-0295",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2020; 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.