Individual provider Active NPI

Neisha Lestage

  • Mental Health Counselor
  • Tyler, TX
National Provider Identifier
1982670865
Registry record updated Mar 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
15061 Issued in TX
Practice address
2323 W Front St
Tyler, TX 75702-7704
Phone
(903) 597-1351
Fax
(903) 535-7386
NPI assigned
Feb 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 15061 TX Primary

Addresses

Primary practice location

2323 W Front St
Tyler, TX 75702-7704

Mailing address

2323 W Front St
Tyler, TX 75702-7704
Phone (903) 597-1351

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20240404001037 TX Practitioner - Mental Health Counselor 5496193898 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15061TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Andrews Center -Pinkerton CurrentSince Mar 21, 2024 Accepting new patients
Andrews Center/ Phillips CurrentSince Mar 21, 2024 Accepting new patients
Andrews Center Mental Health Current Accepting new patients
Andrews Center - MH Past Accepting new patients
Andrews Center - Mr Past Accepting new patients
Andrews Center - Elliott St Past Accepting new patients

Locations

6901 State Highway 19 S
Athens, TX 75751
Phone (903) 675-8541

575 W State Highway 243
Canton, TX 75103
Phone (903) 567-4197

1738 Elliot Dr
Canton, TX 75103
Phone (903) 597-5067

575 W State Highway 243
Ste 243
Canton, TX 75103

1174 E Lennon Dr
Ste C
Emory, TX 75440
Phone (903) 473-2652

703 W Patten St
Mineola, TX 75773
Phone (903) 569-5409

2323 W Front St
Tyler, TX 75702
Phone (903) 535-7355

1722 W Front St
Tyler, TX 75702
Phone (903) 593-4004

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1982670865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2323 W FRONT ST",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757027704",
            "telephone_number": "903-597-1351",
            "fax_number": "903-535-7386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2323 W FRONT ST",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757027704",
            "telephone_number": "903-597-1351",
            "fax_number": "903-535-7386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LESTAGE",
        "first_name": "NEISHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-28",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "15061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.