Individual provider Active NPI

Solanja Perez-Rede, LPC

  • Mental Health Counselor
  • El Paso, TX
National Provider Identifier
1205000635
Registry record updated Mar 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
62573 Issued in TX
Practice address
105 E Castellano Dr
El Paso, TX 79912-6435
Phone
(915) 861-9056
Fax
(877) 587-9452
NPI assigned
Apr 16, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2012

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 62573 TX Primary

Addresses

Primary practice location

105 E Castellano Dr
El Paso, TX 79912-6435

Mailing address

105 E Castellano Dr
El Paso, TX 79912-6435
Phone (915) 861-9056

Other identifiers 1

IdentifierTypeStateIssuer
198783605MedicaidTX

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
I20260529002013 TX Practitioner - Mental Health Counselor 8426528597 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2005
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4855 N Mesa St
Suite 126I
El Paso, TX 79912-5939

5912 Los Pueblos Dr
El Paso, TX 79912-7518

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
62573TXMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Therapy Corner P. L. L. C. Mental Health 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.

NPI Registry JSON

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

{
    "created_epoch": "1208304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332633600000",
    "number": "1205000635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 E CASTELLANO DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799126435",
            "telephone_number": "915-861-9056",
            "fax_number": "877-587-9452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 E CASTELLANO DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799126435",
            "telephone_number": "915-861-9056",
            "fax_number": "877-587-9452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ-REDE",
        "first_name": "SOLANJA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-16",
        "last_updated": "2012-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "62573",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "198783605",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.