Individual provider Active NPI

Christie Len-Marie Quan, M. ED., LPC, RPT

  • Professional Counselor
  • Bryan, TX
National Provider Identifier
1790558096
Registry record updated Mar 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
73328 Issued in TX
Practice address
748 N Earl Rudder Fwy
Bryan, TX 77802-2914
Phone
(979) 207-2900
NPI assigned
Oct 30, 2023
Last updated
Mar 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 73328 TX Primary

Addresses

Primary practice location

748 N Earl Rudder Fwy
Bryan, TX 77802-2914

Mailing address

PO Box 844658
Dallas, TX 75284-4658
Phone (800) 994-0371

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cquan1282587@direct.sw.org

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
I20240119003861 TX Practitioner - Mental Health Counselor 8426400912 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scott and White ClinicGroup PAC ID 8123923604, 2,426 clinicians

Practice addresses (Care Compare)

748 N Earl Rudder Fwy
Bryan Booneville Clinic
Bryan, TX 77802-2914
Phone (979) 207-2900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Education

Practice roles

OrganizationSpecialtyStatusNew patients
Scott & White Clinic Current Accepting new patients
Scott & White Clinic CurrentSince Jan 1, 2024 Accepting new patients
Scott & White Clinic CurrentSince Jan 1, 2024 Accepting new patients

Locations

748 N Earl Rudder Fwy
Bryan, TX 77802
Phone (979) 207-2900

1280 Arrington Rd
Ste 200
College Station, TX 77845
Phone (979) 207-6550

2401 S 31st St
Temple, TX 76508
Phone (254) 724-2459

2401 S 31st St
#200
Temple, TX 76508
Phone (254) 215-0100

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1698624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709769600000",
    "number": "1790558096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658",
            "telephone_number": "800-994-0371",
            "fax_number": "254-215-9722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "748 N EARL RUDDER FWY",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022914",
            "telephone_number": "979-207-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUAN",
        "first_name": "CHRISTIE",
        "middle_name": "LEN-MARIE",
        "credential": "M. ED., LPC, RPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-30",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "73328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cquan1282587@direct.sw.org",
            "affiliation": "N",
            "address_1": "748 N Earl Rudder Fwy",
            "city": "Bryan",
            "state": "TX",
            "country_code": "US",
            "postal_code": "778022914",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bryan, TX

Sources for this page

Verify at the official NPI Registry.