Individual provider Active NPI

Kristy Meador, LPC

  • Counselor
  • Decatur, TX
National Provider Identifier
1487293551
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
79225 Issued in TX
Practice address
2201 S FM 51 Ste a
Decatur, TX 76234-3746
Phone
(817) 812-2880
Fax
(817) 812-3096
NPI assigned
Jan 6, 2020
Last updated
Jun 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 79225 TX Primary

Addresses

Primary practice location

2201 S FM 51 Ste a
Decatur, TX 76234-3746

Mailing address

4684 Fruitland Rd
Sunset, TX 76270-6575
Phone (817) 313-4432

Other practice location 1

4684 Fruitland Rd
Sunset, TX 76270-6575
Phone (817) 313-4432

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
I20240426000032 TX Practitioner - Mental Health Counselor 3678913548 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Logos Services LLCGroup PAC ID 3476804519, 9 clinicians

Practice addresses (Care Compare)

5751 Park Vista Cir
Suite 101
Fort Worth, TX 76244-5693
Phone (817) 812-2880

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
79225TXMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Logos Services LLC CurrentSince Mar 14, 2024 Accepting new patients
North Texas Addiction Counseling & Education, Inc. PastSince Jul 1, 2021 Accepting new patients

Locations

5751 Park Vista Cir
Ste 101
Fort Worth, TX 76244
Phone 8178122880100

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": "1578268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1487293551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4684 FRUITLAND RD",
            "city": "SUNSET",
            "state": "TX",
            "postal_code": "762706575",
            "telephone_number": "817-313-4432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 S FM 51 STE A",
            "city": "DECATUR",
            "state": "TX",
            "postal_code": "762343746",
            "telephone_number": "817-812-2880",
            "fax_number": "817-812-3096"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4684 Fruitland Rd",
            "address_purpose": "LOCATION",
            "city": "Sunset",
            "state": "TX",
            "postal_code": "762706575",
            "country_code": "US",
            "telephone_number": "817-313-4432",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEADOR",
        "first_name": "KRISTY",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-06",
        "last_updated": "2024-06-19",
        "certification_date": "2022-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TX",
            "license": "79225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, TX

Sources for this page

Verify at the official NPI Registry.