Active NPI
Gwen Self Warren, L.P.C.
- Professional Counselor
- Shallowater, TX
National Provider Identifier
1669668596
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 12031
- Practice address
- 1401 9TH St
Shallowater, TX 79363-5127 - Phone
- (806) 787-3686
- Fax
- (806) 832-1336
- NPI assigned
- Sep 25, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | 12031 | TX | Primary |
Addresses
Primary practice location
1401 9TH St
Shallowater, TX 79363-5127
Mailing address
1401 9TH St
Shallowater, TX 79363-5127
Phone (806) 787-3686
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190678400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190678400000",
"number": "1669668596",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1401 9TH ST",
"city": "SHALLOWATER",
"state": "TX",
"postal_code": "793635127",
"telephone_number": "806-787-3686",
"fax_number": "806-832-1336"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 9TH ST",
"city": "SHALLOWATER",
"state": "TX",
"postal_code": "793635127",
"telephone_number": "806-787-3686",
"fax_number": "806-832-1336"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WARREN",
"first_name": "GWEN",
"middle_name": "SELF",
"credential": "L.P.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-09-25",
"last_updated": "2007-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "12031",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shallowater, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.