Individual provider Active NPI

Rose Brooks Stutes, M.ED., LPC

  • Professional Counselor
  • Beaumont, TX
National Provider Identifier
1447671987
Registry record updated Aug 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
67903 Issued in TX
Practice address
3455 Stagg Dr
Beaumont, TX 77701-4521
Phone
(832) 548-0000
NPI assigned
Dec 31, 2013
Last updated
Aug 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2024

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 67903 TX Primary

Addresses

Primary practice location

3455 Stagg Dr
Beaumont, TX 77701-4521

Mailing address

PO Box 66308
Houston, TX 77266-6308

Other identifiers 1

IdentifierTypeStateIssuer
67903OtherTXTEXAS PROFESSIONAL COUNSELOR LICENSE

Other names 1

  • Rose Ann Brooks Former name

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
I20240124003389 TX Practitioner - Mental Health Counselor 7517310782 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
67903TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Community Health Services, Inc CurrentSince Jan 1, 2024 Accepting new patients
Legacy Community Health Services, Inc CurrentSince Jan 1, 2024 Accepting new patients

Locations

3455 Stagg Dr
Beaumont, TX 77701
Phone (409) 242-2531

4450 Highland Ave
Beaumont, TX 77705
Phone (409) 832-1924

3430 Center St
Deer Park, TX 77536
Phone (832) 266-7303

6441 High Star Dr
Houston, TX 77074
Phone (832) 548-5300

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": "1388448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1447671987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 66308",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772666308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3455 STAGG DR",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777014521",
            "telephone_number": "832-548-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUTES",
        "first_name": "ROSE",
        "middle_name": "BROOKS",
        "name_prefix": "Mrs.",
        "credential": "M.ED., LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-31",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "67903",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS PROFESSIONAL COUNSELOR LICENSE",
            "identifier": "67903",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROSE",
            "last_name": "BROOKS",
            "middle_name": "ANN",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Beaumont, TX

Sources for this page

Verify at the official NPI Registry.