NPIMap

Organization Active NPI

Tyler Counseling & Assessment Center

  • Psychologist
  • Tyler, TX
National Provider Identifier
1659483840
Registry record updated May 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
TYLER COUNSELING & ASSESSMENT CENTER
Doing business as
Tyler Counseling & Assessment Center
Practice address
1121 E Southeast Loop 323
Ste.204
Tyler, TX 75701-9660
Phone
(903) 581-0933
Fax
(903) 581-3977
NPI assigned
Aug 31, 2006
Last updated
May 5, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2021

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

Authorized official

Name
Ron L Roberts, MSNPI 1174635379
Title
President
Phone
(903) 581-0933

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Professional Counselor 101YP2500X
Psychologist 103T00000X Primary
Clinical Social Worker 1041C0700X
Marriage & Family Therapist 106H00000X
Child & Adolescent Psychiatry Physician 2084P0804X

Addresses

Primary practice location

1121 E Southeast Loop 323
Ste.204
Tyler, TX 75701-9660

Mailing address

1121 E Southeast Loop 323
Ste.204
Tyler, TX 75701-9660
Phone (903) 581-0933

Other identifiers 1

IdentifierTypeStateIssuer
080723201MedicaidTX

Other names 1

  • Tyler Counseling & Assessment Center Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620172800000",
    "number": "1659483840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 E SOUTHEAST LOOP 323",
            "address_2": "STE.204",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757019660",
            "telephone_number": "903-581-0933",
            "fax_number": "903-581-3977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 E SOUTHEAST LOOP 323",
            "address_2": "STE.204",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757019660",
            "telephone_number": "903-581-0933",
            "fax_number": "903-581-3977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TYLER COUNSELING & ASSESSMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "RON",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "903-581-0933",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "080723201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tyler Counseling & Assessment Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 5, 2021; 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.