LEGENDARY COUNSELING, PLLC (NPI# 1356953046) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356953046 |
| Entity Type | Organization |
| Organization Name | LEGENDARY COUNSELING, PLLC |
| Practice Address |
120 W 5th St Ste 105 Tyler TX 75701-4053 |
| Practice Telephone | 9032017779 |
| Practice Fax Number | 9032428764 |
| Mailing Telephone | 9032017779 |
| Mailing Fax Number | 9032428746 |
| Enumeration Date | 2020-08-24 |
| Last Update Date | 2020-10-05 |
| Authorized Official Name | ERIN CAMERON (OWNER/PROFESSIONAL COUNSELOR) |
| Authorized Official Telephone | 9032017779 |
| Authorized Official Credential | LPC, NCC, LCDC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities | ||
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities | ||
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Street Address |
120 W 5TH ST STE 105 |
| City | TYLER |
| State | TX |
| Zip Code | 75701-4053 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124642798 | Erin Cameron | Counselor | 120 W 5th St Ste 105, Tyler, TX 75701-4053 | 2020-05-29 |
| 1417565110 | Rachel Renee Spurgeon | Counselor | 120 W 5th St Ste 105, Tyler, TX 75701-4053 | 2020-07-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962057059 | Gonzalo Fernandez | Physical Therapy Assistant | 753 S Beckham Ave, Tyler, TX 75701 | 2019-08-06 |
| 1215422654 | Adrianna Bussell | Nurse Practitioner | 1000 South Beckham, Tyler, TX 75701 | 2018-06-28 |
| 1285128017 | Idowu Akintokunbo Akinyele | Dentist | Aspen Dental, 4164 S Broadway Ave, Tyler, TX 75701 | 2018-06-15 |
| 1992208912 | Heather Renee Vancleave | Occupational Therapy Assistant | 1228 Louann Lane, Tyler, TX 75701 | 2018-03-15 |
| 1497260533 | Smile Workshop Mckinney, Pllc | Dentist | 301 N. Custer Rd, Mckinney, TX 75701 | 2017-12-12 |
| 1396266441 | Eye Surgery Center of East Texas, Pllc | Clinic/Center | 2448 E 5th St, Tyler, TX 75701 | 2017-06-29 |
| 1962936369 | Collins Complete Family Care | Nurse Practitioner | 1910 E Se Loop 323 # 176, Tyler, TX 75701 | 2017-04-12 |
| 1386187052 | Fellowship Health Team LLC | Home Health | 1124 S Fleishel Ave, Tyler, TX 75701 | 2016-11-29 |
| 1205382454 | Brenton Robinson | Nurse Practitioner | 1100 East Lake St, 160, Tyler, TX 75701 | 2016-08-28 |
| 1851846208 | Care First Pharmacy, LLC | Pharmacy | 1910 Roseland Blvd A, Tyler, TX 75701 | 2016-08-15 |
| Find all providers in zip 75701 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407469075 | Jonathan Richard | Counselor | 1015 Trinity Dr, Tyler, TX 75702-8757 | 2020-08-24 |
| 1043829757 | Lenore Strickland | Counselor | 5207 Hollytree Dr Apt 905, Tyler, TX 75703-3446 | 2020-07-28 |
| 1952933749 | Smith County Champions for Children | Counselor | 4883 Hightech Dr, Tyler, TX 75703-2617 | 2020-02-10 |
| 1568934339 | Art of Healing Counseling Center Pllc | Counselor | 1810 Shiloh Rd Ste 601, Tyler, TX 75703-2457 | 2018-12-18 |
| 1992286041 | Christina Michelle Lawrence | Counselor | 2003 Rickety Ln, Tyler, TX 75703-1706 | 2018-08-27 |
| 1174011779 | David Keith Duffey | Counselor | 657 Prestonwood Cir, Tyler, TX 75703-5045 | 2018-04-29 |
| 1962842237 | Jaclyn Nicole Abell | Counselor | 1121 E Southeast Loop 323 Ste 204, Tyler, TX 75701 | 2013-07-01 |
| 1710251012 | St Joseph Counseling & Rehabilitation Services, Inc | Counselor | 3334 S Sw Loop 323, Suite 108, Tyler, TX 75701-9237 | 2012-03-05 |
| 1750602488 | Valerie Kay Holcomb | Counselor | 2624 Kensington Dr, Suite 108, Tyler, TX 75703-2728 | 2010-06-16 |
| 1861665689 | Robin Bivings Fincher | Counselor | 108 E 3rd St, Tyler, TX 75701-3107 | 2008-04-13 |
| Find all providers in TYLER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.