NPIMap

Organization Active NPI

MHMR Authority of Brazos Valley

  • Mental Health Counselor
  • Bryan, TX
National Provider Identifier
1760935720
Registry record updated Jul 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
72167 Issued in TX
Legal business name
MHMR AUTHORITY OF BRAZOS VALLEY
Practice address
804 S Texas Ave
Bryan, TX 77803-3946
Phone
(979) 220-2881
Fax
(979) 821-9486
NPI assigned
Jul 26, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2016

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

Authorized official

Name
Ken Danford
Title
Director Administrative Services
Phone
(979) 822-6467

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 72167 TX Primary

Addresses

Primary practice location

804 S Texas Ave
Bryan, TX 77803-3946

Mailing address

804 S Texas Ave
Bryan, TX 77803-3946
Phone (979) 220-2881

Other identifiers 1

IdentifierTypeStateIssuer
72167OtherTXTEXAS STATE LICENSE

National Provider Directory

National Provider Directory
Tax ID family
MHMR Authority of Brazos Valley5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1469491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469491200000",
    "number": "1760935720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 S TEXAS AVE",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778033946",
            "telephone_number": "979-220-2881",
            "fax_number": "979-821-9486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 S TEXAS AVE",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778033946",
            "telephone_number": "979-220-2881",
            "fax_number": "979-821-9486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MHMR AUTHORITY OF BRAZOS VALLEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-26",
        "last_updated": "2016-07-26",
        "status": "A",
        "authorized_official_last_name": "DANFORD",
        "authorized_official_first_name": "KEN",
        "authorized_official_title_or_position": "DIRECTOR ADMINISTRATIVE SERVICES",
        "authorized_official_telephone_number": "979-822-6467"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "72167",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS STATE LICENSE",
            "identifier": "72167",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryan, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2016; 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.