Active NPI
Denise N Hazen, LPC
- Mental Health Counselor
- Tyler, TX
National Provider Identifier
1962020412
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 1121 E Southeast Loop 323 Ste 103
Tyler, TX 75701-9660 - Phone
- (903) 483-5272
- NPI assigned
- Jul 10, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 83733 | TX | |
| Professional Counselor | 101YP2500X | |||
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
1121 E Southeast Loop 323 Ste 103
Tyler, TX 75701-9660
Mailing address
1121 E Southeast Loop 323 Ste 103
Tyler, TX 75701-9660
Phone (903) 483-5272
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 |
|---|---|---|---|
| 83733 | TX | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Willow Counseling Center | Mental Health | Current | Accepting new patients |
| Bridge Therapeutic Services PLLC | Professional | Past | Accepting new patients |
| Nancy G. Mayer | Professional | Past | Accepting new patients |
Locations
1121 E Southeast Loop 323
Ste 103
Tyler, TX 75701
Phone (903) 483-5272
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Mental Health Counselor
- Tyler, TX
- NPI 1467159350
-
- Professional Counselor
- Tyler, TX
- NPI 1336555499
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1594339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1677801600000",
"number": "1962020412",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1121 E SOUTHEAST LOOP 323 STE 103",
"city": "TYLER",
"state": "TX",
"postal_code": "757019660",
"telephone_number": "903-483-5272"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1121 E SOUTHEAST LOOP 323 STE 103",
"city": "TYLER",
"state": "TX",
"postal_code": "757019660",
"telephone_number": "903-483-5272"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAZEN",
"first_name": "DENISE",
"middle_name": "N",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-07-10",
"last_updated": "2023-03-03",
"certification_date": "2023-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "TX",
"license": "83733",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tyler, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.