Organization Active NPI

Peace Reconnection Care, PLLC

  • Mental Health Counselor
  • Hockley, TX
National Provider Identifier
1447828892
Registry record updated Jun 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
PEACE RECONNECTION CARE, PLLC
Practice address
16006 Ronda Dale Dr
Hockley, TX 77447-7714
Phone
(601) 600-6752
NPI assigned
Jun 14, 2021
Last updated
Jun 14, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2021

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

Authorized official

Name
Marvshricka Quinn, LCSWNPI 1821559444
Title
Owner
Phone
(601) 600-6752

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

16006 Ronda Dale Dr
Hockley, TX 77447-7714

Mailing address

16006 Ronda Dale Dr
Hockley, TX 77447-7714
Phone (601) 600-6752

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210615002741 TX Part B Supplier - Clinic/Group Practice 2365842192 Receives reassigned benefits from 1 practitioner
Practice locations: Cypress, TX

National Provider Directory

National Provider Directory

Locations

14150 Huffmeister Rd
Ste 200203
Cypress, TX 77429
Phone (281) 214-0413

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1623628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623628800000",
    "number": "1447828892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16006 RONDA DALE DR",
            "city": "HOCKLEY",
            "state": "TX",
            "postal_code": "774477714",
            "telephone_number": "601-600-6752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16006 RONDA DALE DR",
            "city": "HOCKLEY",
            "state": "TX",
            "postal_code": "774477714",
            "telephone_number": "601-600-6752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACE RECONNECTION CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-14",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-10",
        "status": "A",
        "authorized_official_last_name": "QUINN",
        "authorized_official_first_name": "MARVSHRICKA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-600-6752",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hockley, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.