Individual provider Active NPI

Nancy E Mayer, LPC

  • Professional Counselor
  • Tyler, TX
National Provider Identifier
1699181198
Registry record updated Oct 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
61238 Issued in TX
Practice address
3800 Paluxy Drive
Ste 240
Tyler, TX 75703-1667
Phone
(903) 283-8729
Fax
(888) 454-9083
NPI assigned
Jul 3, 2014
Last updated
Oct 8, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2015

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 61238 TX Primary

Addresses

Primary practice location

3800 Paluxy Drive
Ste 240
Tyler, TX 75703-1667

Mailing address

1507 Belmont Dr
Tyler, TX 75701-3222
Phone (903) 283-8729

Other identifiers 1

IdentifierTypeStateIssuer
61238OtherTXSTATE LICENSE

Other names 1

  • Nancy Grubb Former name

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
I20240515001610 TX Practitioner - Mental Health Counselor 5991146466 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

215 Winchester Dr
Suite 107
Tyler, TX 75701-8801
Phone (903) 805-9188

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
61238TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Nancy G. Mayer Professional CurrentSince Mar 3, 2024 Accepting new patients
Bridge Therapeutic Services PLLC Professional Past Accepting new patients

Locations

215 Winchester Dr
Ste 107
Tyler, TX 75701
Phone (903) 343-6215

3800 Paluxy Dr
Ste 240
Tyler, TX 75703
Phone (903) 283-8729

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1404345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444262400000",
    "number": "1699181198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 BELMONT DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757013222",
            "telephone_number": "903-283-8729",
            "fax_number": "888-454-9083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 PALUXY DRIVE",
            "address_2": "STE 240",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757031667",
            "telephone_number": "903-283-8729",
            "fax_number": "888-454-9083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYER",
        "first_name": "NANCY",
        "middle_name": "E",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-03",
        "last_updated": "2015-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "61238",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "61238",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NANCY",
            "last_name": "GRUBB",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.