Individual provider Active NPI

Jorge Cea, LPC

  • Professional Counselor
  • Conroe, TX
National Provider Identifier
1073904652
Registry record updated May 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
69287 Issued in TX
Practice address
605 S Conroe Medical Dr
Conroe, TX 77304-4722
Phone
(936) 539-4004
Fax
(936) 539-3635
NPI assigned
Feb 18, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2021

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 69287 TX Primary

Addresses

Primary practice location

605 S Conroe Medical Dr
Conroe, TX 77304-4722

Mailing address

605 S Conroe Medical Dr
Conroe, TX 77304-4722
Phone (936) 539-4004

Other practice location 1

13905 Grangerland Rd
Conroe, TX 77306-7809
Phone (936) 539-4004

Other identifiers 1

IdentifierTypeStateIssuer
3451577-01MedicaidTX

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
I20231120001857 TX Practitioner - Mental Health Counselor 8628426301 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lone Star Community Health Center, IncGroup PAC ID 7416841994, 35 clinicians

Practice addresses (Care Compare)

605 S Conroe Medical Dr
Conroe, TX 77304-4722
Phone (936) 539-4004

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
69287TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Lone Star Community Health Center, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Lone Star Community Health Center, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Lone Star Community Health Center, Inc. Past Accepting new patients
Lone Star Community Health Center, Inc. Past Accepting new patients

Locations

13905 Grangerland Rd
Conroe, TX 77306

605 S Conroe Medical Dr
Conroe, TX 77304

440 Rayford Rd
Ste 150
Spring, TX 77386

9516 FM 1097 Rd W
Ste 140
Willis, TX 77318
Phone (936) 436-5540

Interoperability endpoints

  • Direct secure messaging: jorgecea@lsfhc.allscriptsdirect.net
  • Direct secure messaging: jorge.cea.1@31617.direct.athenahealth.com

Organizations & group practices 4

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": "1424217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620864000000",
    "number": "1073904652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 S CONROE MEDICAL DR",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773044722",
            "telephone_number": "936-539-4004",
            "fax_number": "936-539-3635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 S CONROE MEDICAL DR",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773044722",
            "telephone_number": "936-539-4004",
            "fax_number": "936-539-3635"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13905 Grangerland Rd",
            "address_purpose": "LOCATION",
            "city": "Conroe",
            "state": "TX",
            "postal_code": "773067809",
            "country_code": "US",
            "telephone_number": "936-539-4004",
            "fax_number": "936-521-8449",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CEA",
        "first_name": "JORGE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-02-18",
        "last_updated": "2021-05-13",
        "certification_date": "2021-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "69287",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3451577-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

Verify at the official NPI Registry.