Active NPI
Brenda S. Waggoner, M.S., L.P.C., N.C.C.
- Mental Health Counselor
- Richardson, TX
National Provider Identifier
1689895740
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 14417
- Practice address
- 100 N. Central Expressway
Suite 402
Richardson, TX 75080 - Phone
- (972) 542-7017
- NPI assigned
- May 2, 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 14417 | TX | Primary |
Addresses
Primary practice location
100 N. Central Expressway
Suite 402
Richardson, TX 75080
Mailing address
705 N. Benge Street
McKinney, TX 75069
Phone (972) 238-1200
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14417 | TX | MD | Neurology Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1689895740",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "705 N. BENGE STREET",
"city": "MCKINNEY",
"state": "TX",
"postal_code": "75069",
"telephone_number": "972-238-1200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 N. CENTRAL EXPRESSWAY",
"address_2": "SUITE 402",
"city": "RICHARDSON",
"state": "TX",
"postal_code": "75080",
"telephone_number": "972-542-7017"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGGONER",
"first_name": "BRENDA",
"middle_name": "S.",
"name_prefix": "Ms.",
"credential": "M.S., L.P.C., N.C.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "14417",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richardson, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.