Individual provider Active NPI

Dreamor Mayfield, LPC

  • Professional Counselor
  • Waco, TX
National Provider Identifier
1164080123
Registry record updated Dec 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
74201 Issued in TX
Practice address
6600 Sanger Ave Ste 21
Waco, TX 76710-7805
Phone
(254) 413-0640
NPI assigned
Jun 4, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2023

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 74201 TX Primary

Addresses

Primary practice location

6600 Sanger Ave Ste 21
Waco, TX 76710-7805

Mailing address

636 Apple Cross CT
Robinson, TX 76706-5341
Phone (254) 413-0640

Other identifiers 1

IdentifierTypeStateIssuer
1164080123MedicaidTX

Other names 1

  • Dreamor Mayfield Professional name

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
I20241120003032 TX Practitioner - Mental Health Counselor 4880129378 Practice locations: Waco, TX

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6600 Sanger Ave
Waco, TX 76710-7814
Phone (254) 413-0640

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1559606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702339200000",
    "number": "1164080123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "636 APPLE CROSS CT",
            "city": "ROBINSON",
            "state": "TX",
            "postal_code": "767065341",
            "telephone_number": "254-413-0640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 SANGER AVE STE 21",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767107805",
            "telephone_number": "254-413-0640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYFIELD",
        "first_name": "DREAMOR",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-04",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "74201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164080123",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DREAMOR",
            "last_name": "MAYFIELD",
            "credential": "LPC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Waco, TX

Sources for this page

Verify at the official NPI Registry.