NPIMap

Individual provider Active NPI

Constance Marie Rafailedes, M.A., L.P.C., R.P.T.

  • Mental Health Counselor
  • Cleburne, TX
National Provider Identifier
1376545830
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
10051 Issued in TX
Practice address
1011 Granbury St
Cleburne, TX 76033-5752
Phone
(817) 645-3328
Fax
(817) 558-3203
NPI assigned
Aug 15, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 10051 TX Primary

Addresses

Primary practice location

1011 Granbury St
Cleburne, TX 76033-5752

Mailing address

1011 Granbury St
Cleburne, TX 76033-5752
Phone (817) 645-3328

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
10051TXMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Path Psychological Services PastSince Jun 1, 2020 Accepting new patients
Tara Mitchell, LCSW PastSince Nov 1, 2020 Accepting new patients

Organizations & group practices 2

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": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376545830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 GRANBURY ST",
            "city": "CLEBURNE",
            "state": "TX",
            "postal_code": "760335752",
            "telephone_number": "817-645-3328",
            "fax_number": "817-558-3203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 GRANBURY ST",
            "city": "CLEBURNE",
            "state": "TX",
            "postal_code": "760335752",
            "telephone_number": "817-645-3328",
            "fax_number": "817-558-3203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAFAILEDES",
        "first_name": "CONSTANCE",
        "middle_name": "MARIE",
        "credential": "M.A., L.P.C., R.P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "10051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleburne, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.