Individual provider Active NPI

Vonteshea L Williams, MS, LPC ASSOCIATE

  • Professional Counselor
  • Mansfield, TX
National Provider Identifier
1376226944
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
92505 Issued in TX
Practice address
1285 N Main St Ste 101-5
Mansfield, TX 76063-1511
Phone
(682) 651-7621
Fax
(817) 887-3409
NPI assigned
Aug 10, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 92505 TX Primary

Addresses

Primary practice location

1285 N Main St Ste 101-5
Mansfield, TX 76063-1511

Mailing address

PO Box 163781
Fort Worth, TX 76161-3781
Phone (682) 651-7621

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
I20260402000508 TX Practitioner - Mental Health Counselor 8426533902 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Geode Health of Texas, PLLCGroup PAC ID 2062896897, 158 clinicians

Practice addresses (Care Compare)

3009 E Renner Rd
Suite 120
Richardson, TX 75082-3572
Phone (469) 808-1690

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
92505TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Regal Oak Counseling, LLC Professional PastSince Aug 13, 2023 Accepting new patients

Organizations & group practices 3

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": "1691625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1376226944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 163781",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761613781",
            "telephone_number": "682-651-7621",
            "fax_number": "817-887-3409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1285 N MAIN ST STE 101-5",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760631511",
            "telephone_number": "682-651-7621",
            "fax_number": "817-887-3409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "VONTESHEA",
        "middle_name": "L",
        "credential": "MS, LPC ASSOCIATE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-10",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "92505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, TX

Sources for this page

Verify at the official NPI Registry.