Individual provider Active NPI

Marvin Edson Hughes III

  • Professional Counselor
  • Houston, TX
National Provider Identifier
1104590322
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
10877 Issued in TX
Practice address
3121 Buffalo Speedway
Houston, TX 77098-1971
Phone
(713) 208-8837
NPI assigned
Aug 2, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TC1900X 10877 TX
Professional Counselor 101YP2500X 10877 TX Primary

Addresses

Primary practice location

3121 Buffalo Speedway
Houston, TX 77098-1971

Mailing address

3121 Buffalo Speedway Apt 6204
Houston, TX 77098-1854
Phone (713) 208-8837

Other practice location 1

2000 Crawford St Ste 1650
Houston, TX 77002-1072
Phone (832) 387-4368

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
I20250112000065 TX Practitioner - Mental Health Counselor 4880122365 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10877TXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Innerlight Community Advocates PLLC Professional CurrentSince Nov 26, 2024 Accepting new patients

Locations

2000 Crawford St
Ste 869
Houston, TX 77002
Phone (832) 387-4368

2000 Crawford St
Ste 1650
Houston, TX 77002
Phone (832) 387-4368

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": "1627862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1104590322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3121 BUFFALO SPEEDWAY APT 6204",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770981854",
            "telephone_number": "713-208-8837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3121 BUFFALO SPEEDWAY",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770981971",
            "telephone_number": "713-208-8837"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2000 Crawford St Ste 1650",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770021072",
            "country_code": "US",
            "telephone_number": "832-387-4368",
            "fax_number": "713-347-0899",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUGHES",
        "first_name": "MARVIN",
        "middle_name": "EDSON",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-02",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": "TX",
            "license": "10877",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "10877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.