Individual provider Active NPI

Janet Lynne Bristo, L.P.C.

  • Professional Counselor
  • Vernon, TX
National Provider Identifier
1891895470
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
20003 Issued in TX
Practice address
1914 Paradise St
Vernon, TX 76384-8111
Phone
(940) 553-1631
Fax
(940) 553-1631
NPI assigned
Sep 24, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 20003 TX Primary

Addresses

Primary practice location

1914 Paradise St
Vernon, TX 76384-8111

Mailing address

1914 Paradise St
Vernon, TX 76384-8111
Phone (940) 553-1631

Other identifiers 2

IdentifierTypeStateIssuer
7208LCOtherTXJANET BRISTO BLUECROSS TX
1792681MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20240517001175 OK Practitioner - Mental Health Counselor 0143661439 Practice locations: Lawton, OK

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1988
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

6425 NW Cache Rd
Suite 201
Lawton, OK 73505-3392
Phone (580) 536-6500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20003TXMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1159056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1891895470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1914 PARADISE ST",
            "city": "VERNON",
            "state": "TX",
            "postal_code": "763848111",
            "telephone_number": "940-553-1631",
            "fax_number": "940-553-1631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1914 PARADISE ST",
            "city": "VERNON",
            "state": "TX",
            "postal_code": "763848111",
            "telephone_number": "940-553-1631",
            "fax_number": "940-553-1631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRISTO",
        "first_name": "JANET",
        "middle_name": "LYNNE",
        "name_prefix": "Ms.",
        "credential": "L.P.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-24",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "20003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JANET BRISTO BLUECROSS TX",
            "identifier": "7208LC",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1792681",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vernon, TX

Sources for this page

Verify at the official NPI Registry.