Individual provider Active NPI

Rochelle Middleman, LMFT

  • Marriage & Family Therapist
  • Conroe, TX
National Provider Identifier
1144332446
Registry record updated Nov 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
1671 Issued in TX
Practice address
620 Longmire Rd
Conroe, TX 77304-1819
Phone
(936) 443-9629
Fax
(855) 443-9630
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Addiction (Substance Use Disorder) Counselor 101YA0400X
Mental Health Counselor 101YM0800X
Professional Counselor 101YP2500X
Marriage & Family Therapist 106H00000X 1671 TX Primary

Addresses

Primary practice location

620 Longmire Rd
Conroe, TX 77304-1819

Mailing address

620 Longmire Rd
Conroe, TX 77304-1819
Phone (936) 443-9629

Other identifiers 1

IdentifierTypeStateIssuer
3626871-02MedicaidTX

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
1401TXMDBehavioral Analyst
1671TXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Prevail Counseling and Forensic Mental Health, Mental Health CurrentSince Sep 1, 2023 Accepting new patients

Locations

620 Longmire Rd
Conroe, TX 77304
Phone (855) 443-9629

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700870400000",
    "number": "1144332446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 LONGMIRE RD",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773041819",
            "telephone_number": "936-443-9629",
            "fax_number": "855-443-9630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 LONGMIRE RD",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773041819",
            "telephone_number": "936-443-9629",
            "fax_number": "855-443-9630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIDDLEMAN",
        "first_name": "ROCHELLE",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2023-11-25",
        "certification_date": "2023-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "1671",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3626871-02",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.