Individual provider Active NPI

Rhonda McKinzie, M.S., LPC

  • Counselor
  • Tyler, TX
National Provider Identifier
1700929163
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
13955 Issued in TX
Practice address
2010 Sybil LN
Tyler, TX 75703-1818
Phone
(903) 596-8118
Fax
(903) 596-8125
NPI assigned
Feb 15, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 13955 TX Primary

Addresses

Primary practice location

2010 Sybil LN
Tyler, TX 75703-1818

Mailing address

2010 Sybil LN
Tyler, TX 75703-1818
Phone (903) 596-8118

Other identifiers 1

IdentifierTypeStateIssuer
85207LOtherTXBCBS

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

LicenseStateTypeSpecialty
13955TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Tyler Psychology Group LLP Past Accepting new patients
Psychology Associates of East Texas, LLC. PastSince Dec 1, 2014 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700929163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 SYBIL LN",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757031818",
            "telephone_number": "903-596-8118",
            "fax_number": "903-596-8125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 SYBIL LN",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757031818",
            "telephone_number": "903-596-8118",
            "fax_number": "903-596-8125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKINZIE",
        "first_name": "RHONDA",
        "name_prefix": "Mrs.",
        "credential": "M.S., LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TX",
            "license": "13955",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "85207L",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, 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.

Verify at the official NPI Registry.