| Purple Crayon Counseling, Pllc | |
|
401 E Front St Ste 227 Tyler TX 75702-8219 | |
| (903) 287-0646 | |
| (903) 560-9500 |
| Full Name | Purple Crayon Counseling, Pllc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 401 E Front St Ste 227, Tyler, Texas |
| Authorized Official Name and Position | Nelida Medina (OWNER/CLINICIAN) |
| Authorized Official Contact | 9032870646 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Purple Crayon Counseling, Pllc 10845 County Road 429 Tyler TX 75704-3813 Ph: (903) 714-4991 | Purple Crayon Counseling, Pllc 401 E Front St Ste 227 Tyler TX 75702-8219 Ph: (903) 287-0646 |
| NPI Number | 1003492570 |
|---|---|
| Provider Enumeration Date | 03/23/2021 |
| Last Update Date | 03/23/2021 |
| Certification Date | 03/23/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003492570 | NPI | - | NPPES |
| 405322501 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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