GREEN ACRES BAPTIST CHURCH
NPI 1376228619
Counselor in Tyler, TX

Active since June 15, 2023
5755 EAGLES NEST BLVD STE 4, TYLER, TX 75703(903) 533-1817 Get Directions Write a Review

NPPES record last updated: June 15, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Green Acres Baptist Church NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GREEN ACRES BAPTIST CHURCH (NPI 1376228619) is a healthcare organization registered as a counselor in Tyler, Texas and active in the NPI registry since June 2023. The organization lists Jaime Dawn Cornelius, Clinic Director, as its authorized official.

NPPES Registry Identity

NPI1376228619
Entity TypeOrganization
Primary Taxonomy101Y00000X
Legal Business NameGREEN ACRES BAPTIST CHURCH
Location Address5755 EAGLES NEST BLVD STE 4Tyler, TX 75703-6236
Mailing Address1607 Troup HwyTyler, TX 75701-5799 · (903) 533-1817
Organization SubpartNo
Authorized OfficialJaime Dawn CorneliusClinic Director · (903) 533-1817
Enumeration DateJune 15, 2023
NPPES CertifiedJune 15, 2023
NPI 1376228619 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyCounselorBehavioral Health & Social Service Providers
Taxonomy Code101Y00000X
Definition

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

5755 EAGLES NEST BLVD STE 4, Tyler, TX 75703

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Counselor (Professional)
5755 EAGLES NEST BLVD STE 4
TYLER, TX 75703
Counselor (Professional)
5755 EAGLES NEST BLVD STE 4
TYLER, TX 75703

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Green Acres Baptist Church's NPI number?

The NPI number for Green Acres Baptist Church is 1376228619. It was assigned to this organization in the NPPES registry on June 15, 2023.

Where is Green Acres Baptist Church located?

Green Acres Baptist Church is located at 5755 Eagles Nest Blvd Ste 4, Tyler, TX 75703. The listed phone number is (903) 533-1817.

What is Green Acres Baptist Church's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

When was this NPI record last updated?

The NPPES record for Green Acres Baptist Church was last updated on June 15, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.