Individual provider Active NPI

Xavier Kennedy Simon, LPC

  • Professional Counselor
  • Houston, TX
National Provider Identifier
1093595126
Registry record updated May 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
93146 Issued in TX
Practice address
9111 Willow Meadow Dr
Houston, TX 77031-1121
Phone
(713) 471-5116
NPI assigned
Oct 5, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 93146 TX Primary
Mental Health Counselor 101YM0800X 93146 TX

Addresses

Primary practice location

9111 Willow Meadow Dr
Houston, TX 77031-1121

Mailing address

9111 Willow Meadow Dr
Houston, TX 77031-1121
Phone (713) 471-5116

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
I20250612003337 TX Practitioner - Mental Health Counselor 9133630676 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Texana Center Mental Health CurrentSince May 5, 2025 Accepting new patients

Locations

4910 Airport Ave
Ste D
Rosenberg, TX 77471
Phone (281) 239-1300

Organizations & group practices 1

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": "1696464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747958400000",
    "number": "1093595126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9111 WILLOW MEADOW DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770311121",
            "telephone_number": "713-471-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9111 WILLOW MEADOW DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770311121",
            "telephone_number": "713-471-5116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "XAVIER",
        "middle_name": "KENNEDY",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-10-05",
        "last_updated": "2025-05-23",
        "certification_date": "2025-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "93146",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "93146",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.