Organization Active NPI

Change of Mind Counseling PLLC

  • Counseling Psychologist
  • League City, TX
National Provider Identifier
1023728789
Registry record updated Dec 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
Legal business name
CHANGE OF MIND COUNSELING PLLC
Practice address
202 Reynolds Ave
League City, TX 77573-4159
Phone
(281) 620-9785
NPI assigned
Dec 2, 2022
Last updated
Dec 2, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2022

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

Authorized official

Name
Ms. Rachael Mary Edelman, LPCNPI 1437762721
Title
Owner
Phone
(281) 620-9785

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU
Adult Mental Health Clinic/Center 261QM0850X NU
Counseling Psychologist 103TC1900X NU Primary
Clinical Child & Adolescent Psychologist 103TC2200X NU

Addresses

Primary practice location

202 Reynolds Ave
League City, TX 77573-4159

Mailing address

PO Box 57231
Webster, TX 77598-7231
Phone (281) 620-9785

National Provider Directory

National Provider Directory

Locations

202 Reynolds Ave
League City, TX 77573
Phone (281) 620-9785

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1669939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669939200000",
    "number": "1023728789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 57231",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775987231",
            "telephone_number": "281-620-9785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 REYNOLDS AVE",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775734159",
            "telephone_number": "281-620-9785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGE OF MIND COUNSELING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-02",
        "last_updated": "2022-12-02",
        "certification_date": "2022-12-02",
        "status": "A",
        "authorized_official_last_name": "EDELMAN",
        "authorized_official_first_name": "RACHAEL",
        "authorized_official_middle_name": "MARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "281-620-9785",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in League City, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2022; 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.