Active NPI
Lauren Mendoza
- Professional Counselor
- Fort Worth, TX
National Provider Identifier
1285499590
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 93933
- Practice address
- 4516 Boat Club Rd Ste 106
Fort Worth, TX 76135-7020 - Phone
- (817) 238-0106
- NPI assigned
- Feb 15, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 93933 | TX | Primary |
Addresses
Primary practice location
4516 Boat Club Rd Ste 106
Fort Worth, TX 76135-7020
Mailing address
4601 Black Oak LN
Fort Worth, TX 76114-3419
Phone (361) 449-5635
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 93933 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707955200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707955200000",
"number": "1285499590",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4601 BLACK OAK LN",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761143419",
"telephone_number": "361-449-5635"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4516 BOAT CLUB RD STE 106",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761357020",
"telephone_number": "817-238-0106"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENDOZA",
"first_name": "LAUREN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-02-15",
"last_updated": "2024-02-15",
"certification_date": "2024-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "93933",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.