Individual provider Active NPI

Shawntonyra Wyatt, LMFT

  • Marriage & Family Therapist
  • Houston, TX
National Provider Identifier
1669941357
Registry record updated Aug 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
15355 Vantage Pkwy W Ste 235
Houston, TX 77032-1975
Phone
(281) 891-3760
NPI assigned
Nov 26, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X 202921 TX
Marriage & Family Therapist 106H00000X Primary

Addresses

Primary practice location

15355 Vantage Pkwy W Ste 235
Houston, TX 77032-1975

Mailing address

15355 Vantage Pkwy W Ste 235
Houston, TX 77032-1975

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

LicenseStateTypeSpecialty
202921TXMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Conversation Spot Marriage & Family Therapist CurrentSince Jan 5, 2020 Accepting new patients

Locations

16770 Imperial Valley Dr
Ste 155
Houston, TX 77060

15355 Vantage Pkwy W
Ste 235
Houston, TX 77032
Phone (281) 891-3760

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": "1543190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596585600000",
    "number": "1669941357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15355 VANTAGE PKWY W STE 235",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770321975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15355 VANTAGE PKWY W STE 235",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770321975",
            "telephone_number": "281-891-3760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYATT",
        "first_name": "SHAWNTONYRA",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-26",
        "last_updated": "2020-08-05",
        "certification_date": "2020-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "202921",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 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.