Individual provider Active NPI

Walter Taylor

  • Marriage & Family Therapist
  • Humble, TX
National Provider Identifier
1629460720
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
204824 Issued in TX
Practice address
12726 Cedar Grove CT
Humble, TX 77346-3091
Phone
(213) 810-7602
NPI assigned
Feb 26, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 204824 TX Primary
Marriage & Family Therapist 106H00000X 83773 CA

Addresses

Primary practice location

12726 Cedar Grove CT
Humble, TX 77346-3091

Mailing address

12726 Cedar Grove CT
Humble, TX 77346-3091
Phone (310) 985-1022

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240318002864 TX Practitioner - Marriage and Family Therapist 5395182042

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
83773CAMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Gramercy Therapy Marriage & Family Therapist PastSince Oct 1, 2023 Accepting new patients
Gramercy Therapy PastSince Mar 16, 2021 Accepting new patients

Organizations & group practices 2

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": "1424908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1629460720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12726 CEDAR GROVE CT",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773463091",
            "telephone_number": "310-985-1022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12726 CEDAR GROVE CT",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773463091",
            "telephone_number": "213-810-7602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "WALTER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-02-26",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "204824",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "83773",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Humble, TX

Sources for this page

Verify at the official NPI Registry.