John Edmonson – Professional Counselor in Tioga, TX

Key facts

NPI: 1689155228
Entity type: Individual (NPI type 1)
Primary specialty: Professional Counselor 101YP2500X
License: 66776 (TX)
Practice address: 100 S. Texas St.
Tioga, TX 76271
Phone: (866) 656-8384
NPI assigned: Aug 22, 2018
Sex: Male
Sole proprietor: No

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
66776	TX	MD	Professional Counselor

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Professional Counselor	101YP2500X	66776	TX	Yes

Addresses

Primary practice location

100 S. Texas St.
Tioga, TX 76271

Mailing address

1350 N Greenville Ave Apt 1417
Richardson, TX 75081-2756
Phone (214) 864-2099

Other practice location 1

100 S. Texas St,
Tioga, TX 76271
Phone (866) 656-8384

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 22, 2018.

{
    "created_epoch": "1534896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534896000000",
    "number": "1689155228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 N GREENVILLE AVE APT 1417",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750812756",
            "telephone_number": "214-864-2099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S. TEXAS ST.",
            "city": "TIOGA",
            "state": "TX",
            "postal_code": "76271",
            "telephone_number": "866-656-8384"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 S. Texas St,",
            "address_purpose": "LOCATION",
            "city": "Tioga",
            "state": "TX",
            "postal_code": "76271",
            "country_code": "US",
            "telephone_number": "866-656-8384",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDMONSON",
        "first_name": "JOHN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-22",
        "last_updated": "2018-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "66776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tioga, TX

All providers in Tioga, TX · Professional Counselor in Texas

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2018. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.