Individual provider Active NPI

Blane Brazier

  • Mental Health Counselor
  • Dallas, TX
National Provider Identifier
1790475705
Registry record updated Sep 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
87756 Issued in TX
Practice address
8604 Greenville Ave Ste 201
Dallas, TX 75243-7148
Phone
(469) 834-5115
NPI assigned
May 11, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 87756 TX Primary

Addresses

Primary practice location

8604 Greenville Ave Ste 201
Dallas, TX 75243-7148

Mailing address

1808 Serenade LN
Richardson, TX 75081-4763
Phone (469) 834-5115

Other practice location 1

1808 Serenade Ln
Richardson, TX 75081-4763
Phone (469) 834-5115

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231122001217 TX Practitioner - Mental Health Counselor 0749638260 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8604 Greenville Ave
Suite 201
Dallas, TX 75243-7148
Phone (469) 834-5115

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lost Stories Counseling Services PLLC Mental Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

8604 Greenville Ave
Ste 201
Dallas, TX 75243
Phone (214) 775-0099

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": "1683763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1790475705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1808 SERENADE LN",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750814763",
            "telephone_number": "469-834-5115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8604 GREENVILLE AVE STE 201",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752437148",
            "telephone_number": "469-834-5115"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1808 Serenade Ln",
            "address_purpose": "LOCATION",
            "city": "Richardson",
            "state": "TX",
            "postal_code": "750814763",
            "country_code": "US",
            "telephone_number": "469-834-5115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRAZIER",
        "first_name": "BLANE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-11",
        "last_updated": "2023-09-19",
        "certification_date": "2023-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "87756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.