Individual provider Active NPI

Monique Mitchell

  • Professional Counselor
  • Conroe, TX
National Provider Identifier
1487122214
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
87488 Issued in TX
Practice address
902 N San Jacinto St
Conroe, TX 77301-2522
Phone
(936) 529-0374
NPI assigned
Nov 9, 2018
Last updated
Mar 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

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 87488 TX Primary

Addresses

Primary practice location

902 N San Jacinto St
Conroe, TX 77301-2522

Mailing address

902 N San Jacinto St
Conroe, TX 77301-2522

Other practice location 1

350 N Sam Houston Pkwy E
Houston, TX 77060-3315
Phone (832) 761-3176

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
I20240611003507 TX Practitioner - Mental Health Counselor 8729520234 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
87488TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Serenity Ranch Wellness, PLLC Professional CurrentSince Jun 5, 2024 Accepting new patients

Locations

902 N San Jacinto St
Conroe, TX 77301
Phone (936) 529-0374

902 N San Jacinto St
Ofc
Conroe, TX 77301
Phone (936) 529-0374

Organizations & group practices 1

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": "1541721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741651200000",
    "number": "1487122214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 N SAN JACINTO ST",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773012522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 N SAN JACINTO ST",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773012522",
            "telephone_number": "936-529-0374"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 N Sam Houston Pkwy E",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770603315",
            "country_code": "US",
            "telephone_number": "832-761-3176",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "MONIQUE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-09",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "87488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

Verify at the official NPI Registry.