Brandon Michael Roberts, M.ED., NCC, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

77674 Issued in TX

Practice address

1219 Dallas St
Port Neches, TX 77651-2908

Phone

(409) 234-5777

Fax

(877) 250-4835

NPI assigned

Dec 4, 2018

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Education

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Deer Oaks Geriatric Services P C

  • Clinical Psychologist
  • San Antonio, TX
  • NPI 1134169287

  Single Specialty

  Medicare reassignment NPD
• Steadfast Health & Wellness PLLC

  • Professional Counselor
  • Port Neches, TX
  • NPI 1003588856
  NPD Authorized official
• Deer Oaks Mental Health Associates PC

  • Clinical Psychologist
  • Las Cruces, NM
  • NPI 1134175763

  Single Specialty

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1543881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645660800000",
    "number": "1003386988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1219 DALLAS ST",
            "city": "PORT NECHES",
            "state": "TX",
            "postal_code": "776512908",
            "telephone_number": "409-234-5777",
            "fax_number": "877-250-4835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1219 DALLAS ST",
            "city": "PORT NECHES",
            "state": "TX",
            "postal_code": "776512908",
            "telephone_number": "409-234-5777",
            "fax_number": "877-250-4835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "BRANDON",
        "middle_name": "MICHAEL",
        "credential": "M.ED., NCC, LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-12-04",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "77674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela R Prince, LPC
• Ignacio Mark Ramirez, MSN FNP-C
• Stephen Larry Reid, FNP
• Retail Investors of Texas, LTD.
• Richard G Bowling
• Misti Michelle Sanchez, RD, LD, CSP
• Erin Rutledge Shaw, FNP-C
• Lisa L Shoemaker
• Cristina Sifuentes-Ayala, PA-C, MS,RD,IBCLC
• Derrick Floyd Simmons, O.D.

• Professional Counselor in Port Neches, TX
• Providers in Port Neches, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.