ANDRE DESHONG (NPI# 1467683078) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467683078 |
| Entity Type | Individual |
| Full Name | ANDRE DESHONG |
| Credential | LCDC |
| Practice Address |
2323 W Front St Tyler TX 75702-7704 |
| Practice Telephone | 9035971351 |
| Practice Fax Number | 9035357386 |
| Mailing Telephone | 9035971351 |
| Mailing Fax Number | 9035357386 |
| Enumeration Date | 2009-07-30 |
| Last Update Date | 2009-07-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
10930 | TX | Behavioral Health & Social Service Providers |
| Street Address |
2323 W FRONT ST |
| City | TYLER |
| State | TX |
| Zip Code | 75702-7704 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619967569 | Jan Lorenz | Nurse Practitioner | 2323 W Front St, Tyler, TX 75702-7704 | 2005-10-24 |
| 1982240776 | Pamela Summers | Nurse Practitioner | 2323 W Front St, Tyler, TX 75702-7747 | 2019-11-27 |
| 1154833713 | Cieja Chapman | Nurse Practitioner | 2323 W Front St, Tyler, TX 75702-7704 | 2017-11-03 |
| 1184159097 | Alex Park | Pharmacist | 2323 W Front St, Tyler, TX 75702-7704 | 2017-04-28 |
| 1548706815 | Mollie Eaton | Behavioral Analyst | 2323 W Front St, Tyler, TX 75702-7704 | 2017-01-11 |
| 1538604715 | Andrews Center -pinkerton | Social Worker | 2323 W Front St, Tyler, TX 75702-7704 | 2016-12-27 |
| 1609310150 | Rachel Massey | Behavioral Analyst | 2323 W Front St, Tyler, TX 75702-7704 | 2016-12-16 |
| 1871948992 | Alexandra Smith | Physician Assistant | 2323 W Front St, Tyler, TX 75702-7704 | 2016-04-26 |
| 1952773293 | Susan Blalock | Counselor | 2323 W Front St, Tyler, TX 75702-7704 | 2015-10-27 |
| 1851777148 | Andrews Center/drop In | Community Based Residential Treatment Facility, Mental Illness | 2323 W Front St, Tyler, TX 75702-7704 | 2015-08-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679116610 | Tiffiney Mcmakin | Nurse Practitioner | 810 E Houston St # 100, Tyler, TX 75702 | 2019-10-22 |
| 1659852507 | Krystal Gayle Lilley | Licensed Vocational Nurse | 100 E Ferguson St Ste 60a, Tyler, TX 75702 | 2018-08-28 |
| 1679029383 | Cynthia Lynn Kalawe | Physical Therapist | 100 E Ferguson, Suite 1204, Tyler, TX 75702 | 2016-09-01 |
| 1649623646 | Susan E Oxford | Social Worker | 13495 Frankston Highway, Tyler, TX 75702 | 2016-07-14 |
| 1053769281 | All Kidz Kan | Home Health | 2902 E Front St, Tyler, TX 75702 | 2016-05-27 |
| 1821415639 | Heather Mullins | Physical Therapy Assistant | 100 E. Ferguson Ste.1204, Tyler, TX 75702 | 2014-03-19 |
| 1346671336 | Dennis Keith Johnson | Dentist | 3081 Hwy. 31 East, Tyler, TX 75702 | 2013-12-02 |
| 1275882201 | Bobby Gibson | Counselor | 401 East Front Street, Ste 233, Tyler, TX 75702 | 2012-09-06 |
| 1144596792 | Tina Marie Borke | Clinical Neuropsychologist | 719 West Front St., Tyler, TX 75702 | 2012-03-28 |
| 1457629529 | James Whaley Rapp | Specialist/Technologist | 430 South Beckham Avenue, Trinity Mother Frances Sports Medicine, Tyler, TX 75702 | 2011-12-05 |
| Find all providers in zip 75702 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124642798 | Erin Cameron | Counselor | 120 W 5th St Ste 105, Tyler, TX 75701-4053 | 2020-05-29 |
| 1376162354 | Noel M Slagle | Counselor | 114 Jordan Plaza Blvd, Tyler, TX 75704-2056 | 2020-04-10 |
| 1982256665 | Amy Lynn Chapmond | Counselor | 114 Jordan Plaza Blvd Ste 302306, Tyler, TX 75704-2056 | 2019-07-12 |
| 1063070209 | Susan Michele Whitaker | Counselor | The Beginning, 114 Jordan Plaza Blvd Suite 302, Tyler, TX 75704 | 2019-06-03 |
| 1477111995 | Alma Bluesummers | Counselor | 114 Jordan Plaza Blvd Ste 302, Tyler, TX 75704-2056 | 2019-05-30 |
| 1669937041 | Bonnie Ann Blattman Beaulieu | Counselor | 3400 Nne Loop 323 Trlr 34, Tyler, TX 75708-5607 | 2019-02-09 |
| 1821577628 | Jahn Quattlebaum | Counselor | 6200 Wilshire Dr, Tyler, TX 75703-4159 | 2018-08-13 |
| 1831684349 | Andrew Bednarek | Counselor | 1510 S. Vine Street, Tyler, TX 75771 | 2018-06-27 |
| 1811482581 | Robert M Parnell | Counselor | 1510 S Vine Ave, Tyler, TX 75701-2826 | 2018-06-26 |
| 1902309487 | Tina Renae Huseth | Counselor | 11849 County Road 461, Tyler, TX 75706-4823 | 2018-03-12 |
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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.