Individual provider Active NPI

Justin Alexander, M.A., LPC

  • Professional Counselor
  • Victoria, TX
National Provider Identifier
1346542701
Registry record updated Jun 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
64559 Issued in TX
Practice address
1402 Village Dr Ste a
Victoria, TX 77901
Phone
(361) 894-8734
Fax
(361) 894-8735
NPI assigned
Nov 17, 2010
Last updated
Jun 28, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 64559 TX
Professional Counselor 101YP2500X 64559 TX Primary

Addresses

Primary practice location

1402 Village Dr Ste a
Victoria, TX 77901

Mailing address

1402 Village Dr Ste a
Victoria, TX 77901-4157
Phone (361) 894-8734

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
I20231130000158 TX Practitioner - Mental Health Counselor 0648628727 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2007
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3571 Far W Blvd
Suite 3291
Austin, TX 78731-3064

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
64559TXMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Brightside Medical, P.C. CurrentSince Jan 1, 2024 Accepting new patients
Raul R Capitaine Mdpa PastSince Apr 24, 2020 Accepting new patients

Locations

2261 Market St
San Francisco, CA 94114
Phone (213) 337-4615

3571 Far West Blvd
Austin, TX 78731
Phone (512) 567-4737

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1289952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530144000000",
    "number": "1346542701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1402 VILLAGE DR STE A",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779014157",
            "telephone_number": "361-894-8734",
            "fax_number": "361-894-8735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 VILLAGE DR STE A",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "77901",
            "telephone_number": "361-894-8734",
            "fax_number": "361-894-8735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEXANDER",
        "first_name": "JUSTIN",
        "name_prefix": "Mr.",
        "credential": "M.A., LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-17",
        "last_updated": "2018-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "64559",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "64559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victoria, TX

Sources for this page

Verify at the official NPI Registry.