Individual provider Active NPI

Kanisha Hill

  • Mental Health Counselor
  • Sanford, NC
National Provider Identifier
1164112637
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
89923 Issued in TX
Practice address
500 Westover Dr # 13619
Sanford, NC 27330-8941
Phone
(323) 205-7088
NPI assigned
May 9, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 89923 TX Primary

Addresses

Primary practice location

500 Westover Dr # 13619
Sanford, NC 27330-8941

Mailing address

230 Sarlee Dr
La Marque, TX 77568-6258
Phone (409) 989-8027

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
I20250123003903 TX Practitioner - Mental Health Counselor 7315476165 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Resilience Center of Houston LLCGroup PAC ID 6305131517, 51 clinicians

Practice addresses (Care Compare)

24044 Cinco Village Ctr Blvd
Suite 100
Katy, TX 77494-8433
Phone (346) 206-3992

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
89923TXMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Resilience Center of Houston, LLC Mental Health CurrentSince Jan 1, 2025 Accepting new patients
Shine Medical Providers PC Past Accepting new patients

Locations

14930 Mueschke Rd
Ste 100
Cypress, TX 77433
Phone (713) 826-8150

24044 Cinco Village Center Blvd
Ste 100
Katy, TX 77494
Phone (713) 332-2788

8665 New Trails Dr
Ste 185
The Woodlands, TX 77381

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1683590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1164112637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 SARLEE DR",
            "city": "LA MARQUE",
            "state": "TX",
            "postal_code": "775686258",
            "telephone_number": "409-989-8027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 WESTOVER DR # 13619",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273308941",
            "telephone_number": "323-205-7088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILL",
        "first_name": "KANISHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-09",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "89923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sanford, NC

Sources for this page

Verify at the official NPI Registry.