Individual provider Active NPI

Elena Rybalko Fernandez, MED, NCC, LPC-A

  • Professional Counselor
  • Pearland, TX
National Provider Identifier
1467283580
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
95711 Issued in TX
Practice address
10907 Memorial Hermann Dr Ste 340
Pearland, TX 77584-4194
Phone
(346) 633-3642
NPI assigned
Aug 10, 2024
Last updated
Aug 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 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 95711 TX Primary

Addresses

Primary practice location

10907 Memorial Hermann Dr Ste 340
Pearland, TX 77584-4194

Mailing address

10907 Memorial Hermann Dr Ste 340
Pearland, TX 77584-4194
Phone (346) 633-3642

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
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
95711TXMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1723248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1467283580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10907 MEMORIAL HERMANN DR STE 340",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775844194",
            "telephone_number": "346-633-3642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10907 MEMORIAL HERMANN DR STE 340",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775844194",
            "telephone_number": "346-633-3642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "ELENA",
        "middle_name": "RYBALKO",
        "credential": "MED, NCC, LPC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-10",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "95711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pearland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; 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.