Individual provider Active NPI

Maxi Malone, LPC

  • Professional Counselor
  • Dallas, TX
National Provider Identifier
1104381482
Registry record updated May 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
77498 Issued in TX
Practice address
8915 Harry Hines Blvd
Dallas, TX 75235-1717
Phone
(214) 351-3190
NPI assigned
Jan 31, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2019

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 77498 TX Primary

Addresses

Primary practice location

8915 Harry Hines Blvd
Dallas, TX 75235-1717

Mailing address

3902 Copeland St
Dallas, TX 75210-2119
Phone (214) 830-6742

Other practice location 1

4100 Spring Valley Rd Ste 515
Dallas, TX 75244-3803
Phone (817) 751-7802

Other practice location 2

11551 Forest Central Dr Ste 202
Dallas, TX 75243-3919
Phone (817) 751-7802

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
I20240604002218 TX Practitioner - Mental Health Counselor 6103368378 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thrive Counseling LLCGroup PAC ID 0749458420, 1,187 clinicians

Practice addresses (Care Compare)

3705 Lakeview Pkwy
Suite 301
Rowlett, TX 75088-4179
Phone (855) 284-7483

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Counseling LLC CurrentSince May 21, 2024 Accepting new patients
PHC of Buffalo Grove Clinical Psychology PastSince Jul 1, 2017 Accepting new patients
Progressive Behavioral Health, PLLC Professional PastSince Feb 14, 2023 Accepting new patients

Locations

1000 Post and Paddock St
Ste 102
Grand Prairie, TX 75050

825 W Royal Ln
Ste 220
Irving, TX 75039

3705 Lakeview Pkwy
Ste 301
Rowlett, TX 75088

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": "1548892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557878400000",
    "number": "1104381482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3902 COPELAND ST",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752102119",
            "telephone_number": "214-830-6742",
            "fax_number": "847-859-5885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8915 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752351717",
            "telephone_number": "214-351-3190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4100 Spring Valley Rd Ste 515",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752443803",
            "country_code": "US",
            "telephone_number": "817-751-7802",
            "fax_number": "847-859-5885",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11551 Forest Central Dr Ste 202",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752433919",
            "country_code": "US",
            "telephone_number": "817-751-7802",
            "fax_number": "847-859-5885",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALONE",
        "first_name": "MAXI",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-31",
        "last_updated": "2019-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "77498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.