Active NPI
Carolyn K McComis, MED., LPC
- Professional Counselor
- Decatur, TX
National Provider Identifier
1760563514
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 19764
- Practice address
- 101 S Trinity St
Decatur, TX 76234-1819 - Phone
- (940) 627-1630
- Fax
- (940) 626-3741
- NPI assigned
- Oct 18, 2006
- 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 | 19764 | TX | Primary |
Addresses
Primary practice location
101 S Trinity St
Decatur, TX 76234-1819
Mailing address
101 S Trinity St
Decatur, TX 76234-1819
Phone (940) 627-1630
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 175788201 | Medicaid | TX | |
| 84788L | Other | TX | BCBS PROVIDER NUMBER |
| 10035138 | Other | TX | AMERIGROUP PROV. NUMBER |
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 Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19764 | TX | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carolyn McComis | Professional | Past | Accepting new patients |
Organizations & group practices 1
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": "1161129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1301011200000",
"number": "1760563514",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 S TRINITY ST",
"city": "DECATUR",
"state": "TX",
"postal_code": "762341819",
"telephone_number": "940-627-1630",
"fax_number": "940-626-3741"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 S TRINITY ST",
"city": "DECATUR",
"state": "TX",
"postal_code": "762341819",
"telephone_number": "940-627-1630",
"fax_number": "940-626-3741"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCOMIS",
"first_name": "CAROLYN",
"middle_name": "K",
"credential": "MED., LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-18",
"last_updated": "2011-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "19764",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "175788201",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER NUMBER",
"identifier": "84788L",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP PROV. NUMBER",
"identifier": "10035138",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Decatur, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.