Individual provider Active NPI

Amanda Esquivel, LPC, LCDC

  • Counselor
  • Garland, TX
National Provider Identifier
1386064731
Registry record updated Apr 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
68781 Issued in TX
Practice address
3256 Southern Dr Ste 461
Garland, TX 75043-1533
Phone
(214) 385-5445
NPI assigned
Apr 24, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Counselor 101Y00000X 68781 TX Primary

Addresses

Primary practice location

3256 Southern Dr Ste 461
Garland, TX 75043-1533

Mailing address

3256 Southern Dr Ste 461
Garland, TX 75043-1533
Phone (214) 385-5445

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
I20240116004601 TX Practitioner - Mental Health Counselor 3971958109 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2010
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Room for ChangeGroup PAC ID 2365894284, 11 clinicians

Practice addresses (Care Compare)

618 Clara Barton Blvd
Suite 7
Garland, TX 75042-5731
Phone (214) 385-5445

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
68781TXMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Blueprints at Room for Change PLLC CurrentSince Sep 14, 2023 Accepting new patients
Room for Change Counselor CurrentSince Jan 3, 2024 Accepting new patients

Locations

3256 Southern Dr
Ste 461
Garland, TX 75043
Phone (469) 344-6639

618 Clara Barton Blvd
Ste 7
Garland, TX 75042
Phone (972) 382-5779

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": "1398297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1386064731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3256 SOUTHERN DR STE 461",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750431533",
            "telephone_number": "214-385-5445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3256 SOUTHERN DR STE 461",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750431533",
            "telephone_number": "214-385-5445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESQUIVEL",
        "first_name": "AMANDA",
        "credential": "LPC, LCDC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-24",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TX",
            "license": "68781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garland, TX

Sources for this page

Verify at the official NPI Registry.