Organization Active NPI

Koinonos Health Care LLC

  • Mental Health Counselor
  • Houston, TX
National Provider Identifier
1174107304
Registry record updated May 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
KOINONOS HEALTH CARE LLC
Practice address
17431 Crosscove CT
Houston, TX 77095-4495
Phone
(832) 951-5482
NPI assigned
May 12, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2021

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

Authorized official

Name
Jennifer AmadasuNPI 1649770371
Title
Ceo
Phone
(832) 951-5482

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

17431 Crosscove CT
Houston, TX 77095-4495

Mailing address

17431 Crosscove CT
Houston, TX 77095-4495
Phone (832) 951-5482

Other identifiers 1

IdentifierTypeStateIssuer
R58638245OtherTXBLUECROSS BLUESHIELD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1620777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621123200000",
    "number": "1174107304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17431 CROSSCOVE CT",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770954495",
            "telephone_number": "832-951-5482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17431 CROSSCOVE CT",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770954495",
            "telephone_number": "832-951-5482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOINONOS HEALTH CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-12",
        "last_updated": "2021-05-16",
        "certification_date": "2021-05-16",
        "status": "A",
        "authorized_official_last_name": "AMADASU",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "832-951-5482"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "R58638245",
            "state": "TX"
        }
    ],
    "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 May 16, 2021; 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.