Active NPI
Clay Brooks, LPC
- Counselor
- Longview, TX
National Provider Identifier
1609171107
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 51872
- Practice address
- 1800 Judson Rd
Suite 100
Longview, TX 75605-4708 - Phone
- (903) 780-6904
- Fax
- (903) 653-4286
- NPI assigned
- Jan 14, 2011
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 51872 | TX | Primary |
Addresses
Primary practice location
1800 Judson Rd
Suite 100
Longview, TX 75605-4708
Mailing address
1800 Judson Rd
Suite 100
Longview, TX 75605-4708
Phone (903) 780-6904
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 |
|---|---|---|---|
| 51872 | TX | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1294963200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1294963200000",
"number": "1609171107",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1800 JUDSON RD",
"address_2": "SUITE 100",
"city": "LONGVIEW",
"state": "TX",
"postal_code": "756054708",
"telephone_number": "903-780-6904",
"fax_number": "903-653-4286"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1800 JUDSON RD",
"address_2": "SUITE 100",
"city": "LONGVIEW",
"state": "TX",
"postal_code": "756054708",
"telephone_number": "903-780-6904",
"fax_number": "903-653-4286"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROOKS",
"first_name": "CLAY",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-01-14",
"last_updated": "2011-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "TX",
"license": "51872",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Longview, TX
- Jessica Lynn Broderick, DO
- Michael Francis Broderick, DO
- Gene Bronson, TX LPC 14451
- Brookridge Internal Medicine Associates, PA
- Chandler Dyan Brooks, FNP
- Delisa Lynn Brooks, APRN,FNP-C, PMHNP-BC
- Brookshire Grocery Company
- Brookshire Grocery Company
- Brookshire Grocery Company
- Jo Ann Broquie, LPC, LSSP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.