NPIMap

Organization Active NPI

East Texas Mental Health Associates

  • Clinical Social Worker
  • Tyler, TX
National Provider Identifier
1649495235
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
02775 Issued in TX
Legal business name
EAST TEXAS MENTAL HEALTH ASSOCIATES
Practice address
5620 Old Bullard Rd
Ste 111
Tyler, TX 75703-4358
Phone
(903) 526-7284
NPI assigned
Apr 17, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Joyce Shayler
Title
Owner
Phone
(903) 526-7284

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 02775 TX Primary

Addresses

Primary practice location

5620 Old Bullard Rd
Ste 111
Tyler, TX 75703-4358

Mailing address

5620 Old Bullard Rd
Ste 111
Tyler, TX 75703-4358

National Provider Directory

National Provider Directory

Locations

1405 S Fleishel Ave
Ste 332
Tyler, TX 75701
Phone (903) 526-7284

1405 S Fleishel Ave
Tyler, TX 75701
Phone (903) 526-7284

5620 Old Bullard Rd
Ste 111
Tyler, TX 75703
Phone (903) 526-7284

Practitioners & affiliated clinicians

Practitioners 6

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": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1649495235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5620 OLD BULLARD RD",
            "address_2": "STE 111",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757034358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5620 OLD BULLARD RD",
            "address_2": "STE 111",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757034358",
            "telephone_number": "903-526-7284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST TEXAS MENTAL HEALTH ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHAYLER",
        "authorized_official_first_name": "JOYCE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-526-7284"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "02775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.