Active NPI
Patrick Shane Beck, LPC
- Professional Counselor
- Mabank, TX
National Provider Identifier
1093336653
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 79454
- Practice address
- 13235 County Road 2925
Mabank, TX 75156-7817 - Phone
- (903) 880-3183
- NPI assigned
- May 5, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 79454 | TX | Primary |
Addresses
Primary practice location
13235 County Road 2925
Mabank, TX 75156-7817
Mailing address
13235 County Road 2925
Mabank, TX 75156-7817
Phone (903) 880-3183
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240422000596 | TX | Practitioner - Mental Health Counselor | 9335535491 | Reassigns benefits to 2 organizations |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sondermind Provider Network LLC | Professional | Current | Accepting new patients |
Locations
2021 Guadalupe St
Ste 260
Austin, TX 78705
Phone (202) 932-9958
Organizations & group practices 2
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": "1588636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1588636800000",
"number": "1093336653",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13235 COUNTY ROAD 2925",
"city": "MABANK",
"state": "TX",
"postal_code": "751567817",
"telephone_number": "903-880-3183"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13235 COUNTY ROAD 2925",
"city": "MABANK",
"state": "TX",
"postal_code": "751567817",
"telephone_number": "903-880-3183"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BECK",
"first_name": "PATRICK",
"middle_name": "SHANE",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-05-05",
"last_updated": "2020-05-05",
"certification_date": "2020-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "79454",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mabank, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.