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Organization
PURPLE CRAYON COUNSELING, PLLC
Active
Organization
PURPLE CRAYON COUNSELING, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NELIDA MEDINA LCSW (OWNER/CLINICIAN)
(903) 287-0646
Entity
Organization
Contact information
Practice address
401 E FRONT ST STE 227, TYLER, TX 75702-8219
(903) 287-0646
(903) 560-9500
Mailing address
10845 COUNTY ROAD 429, TYLER, TX 75704-3813
(903) 714-4991
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
405322501
—
TX
Enumeration date
03/23/2021
Last updated
03/23/2021
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