Active NPI
Krissie Lain Glass, LPC
- Professional Counselor
- Tyler, TX
National Provider Identifier
1750845442
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 67695
- Practice address
- 17121 Highway 69 S
Tyler, TX 75703-8091 - Phone
- (806) 683-7249
- NPI assigned
- Jan 26, 2019
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 67695 | TX | Primary |
Addresses
Primary practice location
17121 Highway 69 S
Tyler, TX 75703-8091
Mailing address
9536 Long Pine CT
Fort Worth, TX 76179-4316
Phone (806) 683-7249
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 |
|---|---|---|---|
| 67695 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548460800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778544000000",
"number": "1750845442",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9536 LONG PINE CT",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761794316",
"telephone_number": "806-683-7249"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17121 HIGHWAY 69 S",
"city": "TYLER",
"state": "TX",
"postal_code": "757038091",
"telephone_number": "806-683-7249"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLASS",
"first_name": "KRISSIE",
"middle_name": "LAIN",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-01-26",
"last_updated": "2026-05-12",
"certification_date": "2026-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "67695",
"primary": true
}
],
"identifiers": [],
"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 May 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.