Active NPI
Brent D Obannon, LPC, LCDC
- Professional Counselor
- Sherman, TX
National Provider Identifier
1912086026
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 13223
- Practice address
- 115 S Travis St
303
Sherman, TX 75090-5990 - Phone
- (903) 813-0723
- Fax
- (903) 813-5452
- NPI assigned
- Nov 2, 2006
- Last updated
- Jul 9, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | 13223 | TX | Primary |
Addresses
Primary practice location
115 S Travis St
303
Sherman, TX 75090-5990
Mailing address
521 Carriage Estates Rd
Sherman, TX 75092-4425
Phone (903) 868-1813
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 |
|---|---|---|---|
| 13223 | TX | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1912086026",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "521 CARRIAGE ESTATES RD",
"city": "SHERMAN",
"state": "TX",
"postal_code": "750924425",
"telephone_number": "903-868-1813"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 S TRAVIS ST",
"address_2": "303",
"city": "SHERMAN",
"state": "TX",
"postal_code": "750905990",
"telephone_number": "903-813-0723",
"fax_number": "903-813-5452"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OBANNON",
"first_name": "BRENT",
"middle_name": "D",
"credential": "LPC, LCDC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-02",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "13223",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sherman, TX
- Nuwell Medical Group Inc (Nuwell Home Healthcare)
- Donald Bichanga Nyamosi
- Shawna O'Donley, PA-C
- Malaika C O'Neal, DDS
- Katie A Oates, LMSW
- Jennifer Obi
- Catherine Nwakego Obiudu, BA; MSC; LVN
- Occupational Health Centers of the Southwest P.a. (Concentra Medical Centers)
- Tyler Michael Ockwig, DO
- Markie Oden, RN, BSN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.