Active NPI
Sara Katrina Wall, LPC
- Professional Counselor
- Canyon, TX
National Provider Identifier
1730888017
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 85301
- Practice address
- 2501 4TH Ave
Canyon, TX 79016-0001 - Phone
- (936) 262-1677
- NPI assigned
- Feb 27, 2023
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 85301 | TX | Primary |
Addresses
Primary practice location
2501 4TH Ave
Canyon, TX 79016-0001
Mailing address
7901 Research Forest Dr Ste 400
Spring, TX 77382-1482
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
| License | State | Type | Specialty |
|---|---|---|---|
| 85301 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1677456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1677456000000",
"number": "1730888017",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7901 RESEARCH FOREST DR STE 400",
"city": "SPRING",
"state": "TX",
"postal_code": "773821482"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2501 4TH AVE",
"city": "CANYON",
"state": "TX",
"postal_code": "790160001",
"telephone_number": "936-262-1677"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALL",
"first_name": "SARA",
"middle_name": "KATRINA",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-02-27",
"last_updated": "2023-02-27",
"certification_date": "2023-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "85301",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canyon, TX
- Connor Vinson, MOT, OTR
- Holly K Waggoner, DPT
- Wal-Mart Stores Texas LLC (Walmart Pharmacy 10-0793)
- Wal-Mart Stores Texas, LP (Vision Center 30-0793)
- Cherish Walker, FNP-C
- Ann S Wallace, MS SPEECH PATHOLOGY
- West Texas a & M University (Speech & Hearing Clinic)
- West Texas a&M University Student Medical Services
- West Texas Medical Management Services LLC
- West Texas Regenerative Medicine Clinic
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.