Individual provider Active NPI

Cynthia Bandemer, MA, MPH, LPC

  • Professional Counselor
  • Houston, TX
National Provider Identifier
1013468073
Registry record updated Jul 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
71796 Issued in TX
Practice address
17300 El Camino Real Ste 107D
Houston, TX 77058
Phone
(281) 787-5558
NPI assigned
Oct 14, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 71796 TX Primary

Addresses

Primary practice location

17300 El Camino Real Ste 107D
Houston, TX 77058

Mailing address

2323 Clear Lake City Blvd Ste 180-308
Houston, TX 77062-8120
Phone (281) 787-5558

Other practice location 1

1335 Regents Park Dr
240
Houston, TX 77058-2540
Phone (713) 222-2525

Other identifiers 1

IdentifierTypeStateIssuer
3650327-01MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
71796TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Clear & Creative Counseling LLC Professional Current Accepting new patients
Innovative Alternatives, Inc. Past Accepting new patients
Innovative Alternatives, Inc. Past Accepting new patients

Locations

17300 El Camino Real
Ste 107D
Houston, TX 77058
Phone (281) 787-5558

2323 Clear Lake City Blvd
Ste 180308
Houston, TX 77062

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": "1476403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531785600000",
    "number": "1013468073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2323 CLEAR LAKE CITY BLVD STE 180-308",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770628120",
            "telephone_number": "281-787-5558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17300 EL CAMINO REAL STE 107D",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77058",
            "telephone_number": "281-787-5558"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1335 Regents Park Dr",
            "address_2": "240",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770582540",
            "country_code": "US",
            "telephone_number": "713-222-2525",
            "fax_number": "281-480-4815",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BANDEMER",
        "first_name": "CYNTHIA",
        "credential": "MA, MPH, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-14",
        "last_updated": "2018-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "71796",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3650327-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.