Clinton R Gholson, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

77796 Issued in TX

Practice address

650 Scarbourough
Canyon Lake, TX 78133-4529

Phone

(830) 964-4390

NPI assigned

Dec 26, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

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

Specialty

Mental Health Counselor

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Anmed HealthGroup PAC ID 1951215243, shared by 12 NPIs, 348 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Anmed Health

  • Family Medicine Physician
  • Anderson, SC
  • NPI 1639102270
  Medicare reassignment NPD
• Anmed Health

  • Emergency Medicine Physician
  • Anderson, SC
  • NPI 1710918321
  Medicare reassignment NPD
• Taral Sharma MD PC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Anderson, SC
  • NPI 1477112597
  Medicare reassignment NPD
• Serenity Fields

  • Developmentally Disabled Services Day Training Agency
  • Bulverde, TX
  • NPI 1033480181
  NPD (past) Authorized official
• Anmed Health

  • Psychiatry Physician
  • Anderson, SC
  • NPI 1184999096
  NPD
• Anmed Health

  • Family Medicine Physician
  • Piedmont, SC
  • NPI 1255137832
  NPD
• Lutheran Social Services of the South, Inc.

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Canyon Lake, TX
  • NPI 1538203484
  NPD (past)
• Stress Management Center, LLC

  • Clinic/Center
  • Anderson, SC
  • NPI 1750558862
  NPD (past)

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

{
    "created_epoch": "1545782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545782400000",
    "number": "1457823734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5447 HAWK EYE DR",
            "city": "BULVERDE",
            "state": "TX",
            "postal_code": "781632255",
            "telephone_number": "210-392-9520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 SCARBOUROUGH",
            "city": "CANYON LAKE",
            "state": "TX",
            "postal_code": "781334529",
            "telephone_number": "830-964-4390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHOLSON",
        "first_name": "CLINTON",
        "middle_name": "R",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-12-26",
        "last_updated": "2018-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "77796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justin H Fuhler, IDMT
• Barbara Gadient
• Deana Garcia, AGACNP
• Kristi D Garza
• Betsy Gholson, LPC
• Sabrina Lynn Gonzalez
• Brooke Goodman, RN
• Howard Ivan Haecker, D.D.S.
• Alyssa Hanson, N.P.
• Jeffrey Quentin Harper, DC

• Professional Counselor in Canyon Lake, TX
• Providers in Canyon Lake, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.