Active NPI
Stephen Wayne Eller, LPC
- Professional Counselor
- Fort Worth, TX
National Provider Identifier
1831543651
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 65921
- Practice address
- 5421 Basswood Blvd
Suite 720
Fort Worth, TX 76137-4482 - Phone
- (682) 237-9855
- NPI assigned
- Apr 18, 2016
- Sex
- Male
- Sole proprietor
- No
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 | 65921 | TX | Primary |
Addresses
Primary practice location
5421 Basswood Blvd
Suite 720
Fort Worth, TX 76137-4482
Mailing address
1209 Sotogrande Blvd Apt 122E
Euless, TX 76040-6096
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 |
|---|---|---|---|
| 65921 | TX | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stephen W Eller, PLLC | 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.
-
- Professional Counselor
- Fort Worth, TX
- NPI 1417301243
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1460937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1460937600000",
"number": "1831543651",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1209 SOTOGRANDE BLVD APT 122E",
"city": "EULESS",
"state": "TX",
"postal_code": "760406096"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5421 BASSWOOD BLVD",
"address_2": "SUITE 720",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761374482",
"telephone_number": "682-237-9855"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLER",
"first_name": "STEPHEN",
"middle_name": "WAYNE",
"name_prefix": "Mr.",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-04-18",
"last_updated": "2016-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "65921",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 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.