Individual provider Active NPI

Andrea Ross

  • Professional Counselor
  • Houston, TX
National Provider Identifier
1104216506
Registry record updated Sep 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
70765 Issued in TX
Practice address
4001 N Shepherd Dr Ste 130
Houston, TX 77018-5588
Phone
(346) 401-8323
NPI assigned
Jan 23, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2019

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
Professional Counselor 101YP2500X 70765 TX Primary

Addresses

Primary practice location

4001 N Shepherd Dr Ste 130
Houston, TX 77018-5588

Mailing address

PO Box 10801
Houston, TX 77206-0801

Other practice location 1

9401 Southwest Fwy
Houston, TX 77074-1407
Phone (713) 970-7000

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
I20260605003503 TX Practitioner - Mental Health Counselor 6800367285 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5500 Guhn Rd
Suite 100
Houston, TX 77040-6161

5500 Guhn Rd
Suite 100
Houston, TX 77040-6162

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
70765TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Another Way Therapeutic Center, PLLC Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1421971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568764800000",
    "number": "1104216506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10801",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772060801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 N SHEPHERD DR STE 130",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770185588",
            "telephone_number": "346-401-8323"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9401 Southwest Fwy",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770741407",
            "country_code": "US",
            "telephone_number": "713-970-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSS",
        "first_name": "ANDREA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-23",
        "last_updated": "2019-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "70765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.