Tristan's Legacy, PLLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

TRISTAN'S LEGACY, PLLC

Practice address

1751 River Run Ste 200
Fort Worth, TX 76107-6670

Phone

(682) 708-0500

NPI assigned

May 27, 2020

Last updated

May 27, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Edward Towns, LPC, LSOTPNPI 1992172753

Title

Executive Director

Phone

(512) 975-9547

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Edward Holt Towns Jr., MA, LPC, LSOTP

  • Professional Counselor
  • Fort Worth, TX
  • NPI 1992172753
  NPD Authorized official

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

{
    "created_epoch": "1590537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590537600000",
    "number": "1922621796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6075 MONTE VISTA LN APT 1621",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761325436",
            "telephone_number": "512-975-9547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1751 RIVER RUN STE 200",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761076670",
            "telephone_number": "682-708-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRISTAN'S LEGACY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-27",
        "last_updated": "2020-05-27",
        "certification_date": "2020-05-27",
        "status": "A",
        "authorized_official_last_name": "TOWNS",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "512-975-9547",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPC, LSOTP"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2020; 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.