Michelle Mixon

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

82766 Issued in TX

Practice address

113 S Lanana St
Nacogdoches, TX 75961-5146

Phone

(936) 209-4090

NPI assigned

Apr 18, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Michelle Jackson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Endeavor Counseling Center PLLC

  • Professional Counselor
  • Nacogdoches, TX
  • NPI 1356040935
  NPD Authorized official
• Whole Again Counseling and Wellness, LLC

  • Professional Counselor
  • Nacogdoches, TX
  • NPI 1114543634
  NPD

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

{
    "created_epoch": "1618704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678060800000",
    "number": "1285215566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1170 COUNTY ROAD 509",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759617999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 S LANANA ST",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759615146",
            "telephone_number": "936-209-4090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1808 South St",
            "address_purpose": "LOCATION",
            "city": "Nacogdoches",
            "state": "TX",
            "postal_code": "759646120",
            "country_code": "US",
            "telephone_number": "936-305-3070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIXON",
        "first_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-18",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "82766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "JACKSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brittany Brown Milstead, LPC
• Mindful Nutrition Counseling LLC
• Mindful Nutrition Counseling LLC
• Max Hamilton Mitchell, PT
• Jerry L Mixon, CRNA
• Mobility Scooters
• Binusha Moitheennazima, MD
• Michael Edward Mollot, M.D.
• Amber Jolene Monk, LVN
• Lawrence Joseph Monlezun, CRNA, MSA

• Professional Counselor in Nacogdoches, TX
• Providers in Nacogdoches, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.