Active NPI
Kristen Eden Warren, LPC
- Professional Counselor
- Benbrook, TX
National Provider Identifier
1114748431
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 83473
- Practice address
- 6420 Southwest Blvd Ste 115
Benbrook, TX 76109-3929 - Phone
- (817) 713-4112
- NPI assigned
- Oct 19, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 83473 | TX | Primary |
Addresses
Primary practice location
6420 Southwest Blvd Ste 115
Benbrook, TX 76109-3929
Mailing address
6420 Southwest Blvd Ste 115
Benbrook, TX 76109-3929
Phone (817) 713-4112
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 83473 | TX | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Billy Max Eden MD PA | Current | Accepting new patients |
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.
-
- Specialist
- Fort Worth, TX
- NPI 1588851174
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1729296000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729296000000",
"number": "1114748431",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6420 SOUTHWEST BLVD STE 115",
"city": "BENBROOK",
"state": "TX",
"postal_code": "761093929",
"telephone_number": "817-713-4112"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6420 SOUTHWEST BLVD STE 115",
"city": "BENBROOK",
"state": "TX",
"postal_code": "761093929",
"telephone_number": "817-713-4112"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WARREN",
"first_name": "KRISTEN",
"middle_name": "EDEN",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-10-19",
"last_updated": "2024-10-19",
"certification_date": "2024-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "83473",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Benbrook, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.