Active NPI
Twyla Michelle Axelson
- Professional Counselor
- Coppell, TX
National Provider Identifier
1669187688
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 90620
- Practice address
- 8951 Cypress Waters Blvd Ste 160
Coppell, TX 75019-4784 - Phone
- (469) 607-0076
- NPI assigned
- Jan 16, 2023
- Last updated
- Jan 16, 2023
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 90620 | TX | Primary |
Addresses
Primary practice location
8951 Cypress Waters Blvd Ste 160
Coppell, TX 75019-4784
Mailing address
5413 Soledad Dr
Denton, TX 76208-6035
Phone (469) 215-0947
Other names 1
- Twyla Clark
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 |
|---|---|---|---|
| 90620 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1673827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673827200000",
"number": "1669187688",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5413 SOLEDAD DR",
"city": "DENTON",
"state": "TX",
"postal_code": "762086035",
"telephone_number": "469-215-0947"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8951 CYPRESS WATERS BLVD STE 160",
"city": "COPPELL",
"state": "TX",
"postal_code": "750194784",
"telephone_number": "469-607-0076"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AXELSON",
"first_name": "TWYLA",
"middle_name": "MICHELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-01-16",
"last_updated": "2023-01-16",
"certification_date": "2023-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "90620",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "TWYLA",
"last_name": "CLARK",
"credential": "LPC-A, MA",
"code": "1",
"type": "Former Name"
}
]
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- Atma II Assistant Living Facility
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- Ashley Velasco Avila
- Joseph O Ayitey-Adjin Jr., DMD
- Aronette Azu, NP
- Sara Bachoo-Ali, RBT
- Back to Eden
- Back to Eden Community Clinic LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.