Brent Parker Tanksley, LCDC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

13677 Issued in TX

Practice address

1501C S Wheeler St
Jasper, TX 75951-5103

Phone

(409) 622-9252

NPI assigned

Oct 20, 2017

Last updated

Nov 29, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1508457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1871004507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1204 JANE AVE",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759011450",
            "telephone_number": "936-674-6559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501C S WHEELER ST",
            "city": "JASPER",
            "state": "TX",
            "postal_code": "759515103",
            "telephone_number": "409-622-9252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANKSLEY",
        "first_name": "BRENT",
        "middle_name": "PARKER",
        "name_prefix": "Mr.",
        "credential": "LCDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-20",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "13677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jimmy W. Spruill, M.D.
• Vicky St John, APRN
• Stat Services of Jasper County a, LLP (Stat Care EMS)
• Stat Services of Jasper County a, LLP (Stat Care EMS)
• Sweet Neches Properties, LTD. (Rayburn Health Care & Rehabilitation)
• Tatum Family Counseling PLLC
• Robert Taylor
• Texas Em-I Medical Services PA
• Therapy Group of Texas, PLLC
• Theraspecialists Inc

• Addiction (Substance Use Disorder) Counselor in Jasper, TX
• Providers in Jasper, TX by specialty
• Addiction (Substance Use Disorder) Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2021; 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.