Individual provider Active NPI

Riya Roney Vettickal

  • Professional Counselor
  • Bellaire, TX
National Provider Identifier
1417725417
Registry record updated Dec 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
81080 Issued in TX
Practice address
4545 Bissonnet St Ste 289
Bellaire, TX 77401-3112
Phone
(832) 463-2502
NPI assigned
Dec 19, 2023
Last updated
Dec 19, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 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 81080 TX Primary

Addresses

Primary practice location

4545 Bissonnet St Ste 289
Bellaire, TX 77401-3112

Mailing address

4545 Bissonnet St Ste 289
Bellaire, TX 77401-3112
Phone (832) 463-2502

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
81080TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Fuller Life Institute CurrentSince Dec 19, 2024 Accepting new patients

Locations

4545 Bissonnet St
Ste 289
Bellaire, TX 77401
Phone (832) 617-4840

Organizations & group practices 1

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": "1702944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702944000000",
    "number": "1417725417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4545 BISSONNET ST STE 289",
            "city": "BELLAIRE",
            "state": "TX",
            "postal_code": "774013112",
            "telephone_number": "832-463-2502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 BISSONNET ST STE 289",
            "city": "BELLAIRE",
            "state": "TX",
            "postal_code": "774013112",
            "telephone_number": "832-463-2502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VETTICKAL",
        "first_name": "RIYA",
        "middle_name": "RONEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-19",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "81080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellaire, TX

Sources for this page

Verify at the official NPI Registry.