Organization Active NPI

Restorative Peace, LLC

  • Professional Counselor
  • Houston, TX
National Provider Identifier
1114706264
Registry record updated Jul 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
RESTORATIVE PEACE, LLC
Practice address
11503 Martin Luther King Blvd
Houston, TX 77048-1867
Phone
(832) 706-2131
NPI assigned
Sep 27, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2024

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

Authorized official

Name
Susie Reyes
Title
Credentialing Specialist
Phone
(210) 833-9382

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

11503 Martin Luther King Blvd
Houston, TX 77048-1867

Mailing address

1560 W Bay Area Blvd Ste 303
Friendswood, TX 77546-2681
Phone (832) 706-2131

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241209002046 TX Part B Supplier - Clinic/Group Practice 3375079742 Receives reassigned benefits from 1 practitioner
Practice locations: Bellaire, TX

National Provider Directory

National Provider Directory

Locations

6300 West Loop S
Ste 235
Bellaire, TX 77401
Phone (713) 839-9186

11503 Martin Luther King Blvd
Houston, TX 77048
Phone (832) 706-2131

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1695772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721952000000",
    "number": "1114706264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1560 W BAY AREA BLVD STE 303",
            "city": "FRIENDSWOOD",
            "state": "TX",
            "postal_code": "775462681",
            "telephone_number": "832-706-2131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11503 MARTIN LUTHER KING BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770481867",
            "telephone_number": "832-706-2131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORATIVE PEACE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-27",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A",
        "authorized_official_last_name": "REYES",
        "authorized_official_first_name": "SUSIE",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "210-833-9382"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.