Individual provider Active NPI

Angi Nicole Watkins

  • Professional Counselor
  • Houston, TX
National Provider Identifier
1063190643
Registry record updated Jul 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
90892 Issued in TX
Practice address
10811 Monroe Rd
Houston, TX 77075-4899
Phone
(713) 740-5460
NPI assigned
Jul 5, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
School Counselor 101YS0200X
Professional Counselor 101YP2500X 90892 TX Primary

Addresses

Primary practice location

10811 Monroe Rd
Houston, TX 77075-4899

Mailing address

611 Hearth Manor Dr
Arcola, TX 77583-4895
Phone (832) 493-0316

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
I20250319003876 TX Practitioner - Mental Health Counselor 3173045101 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Specialty Group PA Mental Health CurrentSince Aug 1, 2025 Accepting new patients
Counseling Connections for Change Inc CurrentSince Mar 7, 2025 Accepting new patients
Shine Medical Providers PC Past Accepting new patients

Locations

600 Congress Ave
Austin, TX 78701
Phone (281) 330-3059

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": "1688515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752537600000",
    "number": "1063190643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 HEARTH MANOR DR",
            "city": "ARCOLA",
            "state": "TX",
            "postal_code": "775834895",
            "telephone_number": "832-493-0316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10811 MONROE RD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770754899",
            "telephone_number": "713-740-5460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATKINS",
        "first_name": "ANGI",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-05",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "90892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.