Individual provider Active NPI

Stephine Denise Reagh, LPC

  • Professional Counselor
  • Tyler, TX
National Provider Identifier
1669815866
Registry record updated Apr 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
67713 Issued in TX
Practice address
3323 SSW Loop 323
Tyler, TX 75701-9221
Phone
(903) 525-9862
NPI assigned
Apr 8, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 67713 TX Primary

Addresses

Primary practice location

3323 SSW Loop 323
Tyler, TX 75701-9221

Mailing address

3700 Appletree LN
Tyler, TX 75701-9301
Phone (903) 736-3572

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
I20240603004257 TX Practitioner - Mental Health Counselor 1759823966 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
67713TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Professional CurrentSince Apr 30, 2024 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

700 Milam St
Ste 1300
Houston, TX 77002
Phone (281) 801-8391

Organizations & group practices 1

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": "1365379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365379200000",
    "number": "1669815866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 APPLETREE LN",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757019301",
            "telephone_number": "903-736-3572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3323 SSW LOOP 323",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757019221",
            "telephone_number": "903-525-9862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REAGH",
        "first_name": "STEPHINE",
        "middle_name": "DENISE",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-08",
        "last_updated": "2013-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "67713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.