Individual provider Active NPI

Keisy Dominique Vasquez, LPC

  • Professional Counselor
  • Houston, TX
National Provider Identifier
1023542453
Registry record updated Dec 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
73762 Issued in TX
Practice address
5616 Lawndale St Ste And400
Houston, TX 77023-3821
Phone
(832) 548-5000
NPI assigned
Apr 12, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2022

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 73762 TX Primary

Addresses

Primary practice location

5616 Lawndale St Ste And400
Houston, TX 77023-3821

Mailing address

5616 Lawndale St Ste And400
Houston, TX 77023-3821
Phone (832) 548-5000

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
I20240209002005 TX Practitioner - Mental Health Counselor 5698118305 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5616 Lawndale St
Houston, TX 77023-3821
Phone (713) 759-0912

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
73762TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Community Health Services, Inc CurrentSince Jan 1, 2024 Accepting new patients
Legacy Community Health Services, Inc CurrentSince Jan 1, 2024 Accepting new patients
Texana Center PastSince Jan 11, 2022 Accepting new patients

Locations

6441 High Star Dr
Houston, TX 77074
Phone (832) 548-5300

5616 Lawndale St
Ste A108
Houston, TX 77023
Phone (713) 759-0912

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": "1491955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672272000000",
    "number": "1023542453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5616 LAWNDALE ST STE AND400",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770233821",
            "telephone_number": "832-548-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5616 LAWNDALE ST STE AND400",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770233821",
            "telephone_number": "832-548-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASQUEZ",
        "first_name": "KEISY",
        "middle_name": "DOMINIQUE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-12",
        "last_updated": "2022-12-29",
        "certification_date": "2022-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "73762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.