Individual provider Active NPI

Antoine Gross Sr., LPC

  • Mental Health Counselor
  • Irving, TX
National Provider Identifier
1053091041
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
87367 Issued in TX
Practice address
1425 Greenway Dr Ste 360
Irving, TX 75038-2447
Phone
(844) 824-8775
Fax
(281) 648-2200
NPI assigned
Jul 24, 2023
Last updated
Nov 4, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 87367 TX Primary
Professional Counselor 101YP2500X 87367 TX

Addresses

Primary practice location

1425 Greenway Dr Ste 360
Irving, TX 75038-2447

Mailing address

1425 Greenway Dr Ste 360
Irving, TX 75038-2447
Phone (844) 824-8775

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

308 S Friendswood Dr
Suite 200
Friendswood, TX 77546-3989

4164 Roosevelt Way
Milton, FL 32583-4017

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
87367TXMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1690156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1053091041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 GREENWAY DR STE 360",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750382447",
            "telephone_number": "844-824-8775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 GREENWAY DR STE 360",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750382447",
            "telephone_number": "844-824-8775",
            "fax_number": "281-648-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSS",
        "first_name": "ANTOINE",
        "name_suffix": "Sr.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-24",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "87367",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "87367",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

Verify at the official NPI Registry.