Individual provider Active NPI

Cody Blake McCain, M.A., LPC

  • Mental Health Counselor
  • Dallas, TX
National Provider Identifier
1275766180
Registry record updated Feb 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
63367 Issued in TX
Practice address
17480 Dallas Pkwy
Ste 114
Dallas, TX 75287-7303
Phone
(214) 202-2264
Fax
(214) 975-6981
NPI assigned
Aug 25, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2017

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 63367 TX Primary

Addresses

Primary practice location

17480 Dallas Pkwy
Ste 114
Dallas, TX 75287-7303

Mailing address

3718 White River
Dallas, TX 75287-4814
Phone (214) 202-2264

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
I20240109000300 TX Practitioner - Mental Health Counselor 9931482916 Practice locations: Celina, TX

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1731 Ellington Dr
Celina, TX 75009-1509
Phone (214) 202-2264

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
63367TXMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1251158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486512000000",
    "number": "1275766180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3718 WHITE RIVER",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752874814",
            "telephone_number": "214-202-2264",
            "fax_number": "214-975-6981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17480 DALLAS PKWY",
            "address_2": "STE 114",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752877303",
            "telephone_number": "214-202-2264",
            "fax_number": "214-975-6981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCAIN",
        "first_name": "CODY",
        "middle_name": "BLAKE",
        "name_prefix": "Mr.",
        "credential": "M.A., LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-08-25",
        "last_updated": "2017-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "63367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.