Individual provider Active NPI

Michelle Bailey Muckelroy, LPC

  • Mental Health Counselor
  • Desoto, TX
National Provider Identifier
1013318534
Registry record updated Dec 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
70094 Issued in TX
Practice address
1636 N Hampton Rd
Desoto, TX 75115-8621
Phone
(281) 773-2897
NPI assigned
Sep 16, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 70094 TX
Mental Health Counselor 101YM0800X 70094 TX Primary
Professional Counselor 101YP2500X 70094 TX

Addresses

Primary practice location

1636 N Hampton Rd
Desoto, TX 75115-8621

Mailing address

1636 N Hampton Rd Ste 101
Desoto, TX 75115-8600
Phone (281) 773-2897

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240430003787 TX Practitioner - Mental Health Counselor 6901246545 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
70094TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Mental Health CurrentSince Mar 27, 2024 Accepting new patients
Beyond the Gray Sky LLC CurrentSince Oct 18, 2025 Accepting new patients
Shine Medical Providers PC Past Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

700 Milam St
Ste 1300
Houston, TX 77002
Phone (281) 801-8391

Networks

  • TX HMO D-SNP
  • NM HMO C-SNP
  • TX HMO

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1410825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765152000000",
    "number": "1013318534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1636 N HAMPTON RD STE 101",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751158600",
            "telephone_number": "281-773-2897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1636 N HAMPTON RD",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751158621",
            "telephone_number": "281-773-2897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUCKELROY",
        "first_name": "MICHELLE",
        "middle_name": "BAILEY",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-16",
        "last_updated": "2025-12-08",
        "certification_date": "2025-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TX",
            "license": "70094",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "70094",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "70094",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Desoto, TX

Sources for this page

Verify at the official NPI Registry.