Individual provider Active NPI

Michaele Ann Bryson, L.P.C.

  • Professional Counselor
  • Gainesville, TX
National Provider Identifier
1629027636
Registry record updated Oct 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
L.P.C.6541 Issued in TX
Practice address
207 S. Dixon Street
Gainesville, TX 76240
Phone
(940) 665-8056
Fax
(940) 665-8057
NPI assigned
May 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6541 TX
Professional Counselor 101YP2500X L.P.C.6541 TX Primary

Addresses

Primary practice location

207 S. Dixon Street
Gainesville, TX 76240

Mailing address

P.O. Box 1416
Gainesville, TX 76241-1416
Phone (940) 665-8056

Other identifiers 2

IdentifierTypeStateIssuer
TPI154260702MedicaidTX
154260701MedicaidTX

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

LicenseStateTypeSpecialty
L.P.C.6541TXMDProfessional Counselor
6541TXMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539216000000",
    "number": "1629027636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1416",
            "city": "GAINESVILLE",
            "state": "TX",
            "postal_code": "762411416",
            "telephone_number": "940-665-8056",
            "fax_number": "940-665-8057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 S. DIXON STREET",
            "city": "GAINESVILLE",
            "state": "TX",
            "postal_code": "76240",
            "telephone_number": "940-665-8056",
            "fax_number": "940-665-8057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYSON",
        "first_name": "MICHAELE",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "L.P.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-08",
        "last_updated": "2018-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "6541",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "L.P.C.6541",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TPI154260702",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154260701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2018; 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.