MR. SAMUEL WYLIE LPC NPI 1639467830

NPI Information

NPI: 1639467830
Provider Name: MR. SAMUEL WYLIE, LPC
Classification: Counselor - 101YP2500X
Entity Type: Individual

Specialization: Professional

Address:
3136 EXECUTIVE DR
SAN ANGELO, TX
ZIP 76904
Phone: (325) 944-3692
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MR. Samuel Wylie, LPC is a professional counselor in San Angelo, TX. MR. Samuel Wylie, LPC NPI is 1639467830. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3136 EXECUTIVE DR
SAN ANGELO, TX
ZIP 76904-802
Phone: (325) 944-3692

The enumeration date for this NPI number is 7/21/2011 and was last updated on 8/22/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YP2500X	Counselor	Professional	11531	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	TPI - 025674502	MEDICAID	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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