Individual provider Active NPI

Cynthia Lee Coronado, ED.D., LPC-S, CAS

  • Professional Counselor
  • Houston, TX
National Provider Identifier
1447654595
Registry record updated Jan 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
67687 Issued in TX
Practice address
1115 Gemini St Ste 200
Houston, TX 77058-2707
Phone
(281) 461-6220
Fax
(833) 593-9064
NPI assigned
Oct 17, 2014
Last updated
Jan 21, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2019

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 67687 TX Primary

Addresses

Primary practice location

1115 Gemini St Ste 200
Houston, TX 77058-2707

Mailing address

7615 Pearson Rd
Santa Fe, TX 77517-3157
Phone (281) 512-1976

Other identifiers 1

IdentifierTypeStateIssuer
1861963001OtherTXGROUP NPI

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

State licenses

LicenseStateTypeSpecialty
67687TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Coronado Counseling Center- Clear Lake Professional Past 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, 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": "1413504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548028800000",
    "number": "1447654595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7615 PEARSON RD",
            "city": "SANTA FE",
            "state": "TX",
            "postal_code": "775173157",
            "telephone_number": "281-512-1976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 GEMINI ST STE 200",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770582707",
            "telephone_number": "281-461-6220",
            "fax_number": "833-593-9064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORONADO",
        "first_name": "CYNTHIA",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "ED.D., LPC-S, CAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-17",
        "last_updated": "2019-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "67687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1861963001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2019; 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.