Individual provider Active NPI

Brisa Celeste Coronado Torres, LPC

  • Professional Counselor
  • Waco, TX
National Provider Identifier
1891577219
Registry record updated Oct 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
1600 Lake Air Dr # 121
Waco, TX 76710-2904
Phone
(254) 340-0893
NPI assigned
Oct 19, 2023
Last updated
Oct 19, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X Primary
Professional Counselor 101YP2500X 84892 TX

Addresses

Primary practice location

1600 Lake Air Dr # 121
Waco, TX 76710-2904

Mailing address

4300 W Waco Dr Ste B2-238
Waco, TX 76710-7010
Phone (254) 548-5805

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

LicenseStateTypeSpecialty
84892TXMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1697673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697673600000",
    "number": "1891577219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 W WACO DR STE B2-238",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767107010",
            "telephone_number": "254-548-5805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 LAKE AIR DR # 121",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767102904",
            "telephone_number": "254-340-0893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORONADO TORRES",
        "first_name": "BRISA",
        "middle_name": "CELESTE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-19",
        "last_updated": "2023-10-19",
        "certification_date": "2022-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "84892",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2023; 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.