Jose Angel Mendoza, LCDC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

84859 Issued in TX

Practice address

4054 McKinney Ave Ste 102
Dallas, TX 75204-2050

Phone

(214) 520-6308

Fax

(214) 521-9172

NPI assigned

May 10, 2021

Last updated

May 10, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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 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

Specialty

Mental Health Counselor

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Children's Health System of Texas

  dba Children's Medical Center of Dallas

  • Children's Hospital
  • Dallas, TX
  • NPI 1194743013
  Medicare reassignment NPD
• Children's Health System of Texas

  dba First Pharmacy Pavilion

  • Community/Retail Pharmacy
  • Dallas, TX
  • NPI 1881830602
  NPD
• Legacy Counseling Center Inc

  • Clinical Social Worker
  • Dallas, TX
  • NPI 1770510075
  NPD

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

{
    "created_epoch": "1620604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620604800000",
    "number": "1497339022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4054 MCKINNEY AVE STE 102",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752042050",
            "telephone_number": "214-520-6308",
            "fax_number": "214-521-9172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4054 MCKINNEY AVE STE 102",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752042050",
            "telephone_number": "214-520-6308",
            "fax_number": "214-521-9172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "JOSE",
        "middle_name": "ANGEL",
        "credential": "LCDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-10",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "84859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diana Mendoza, P.A.
• Elena Mendoza, SLP-ASSISTANT
• Francisco Antonio Mendoza
• Isabel Mendoza
• Jazmin Mendoza
• Lilibeth Mendoza, RBT
• Marie Jemie Mendoza, AG ACNP-BC, ACCNS-BC
• Mary Lyn Mendoza, CRNA
• Mildred Teves Mendoza, AGACNP-BC
• Paul Mendoza, O.D.

• Addiction (Substance Use Disorder) Counselor in Dallas, TX
• Providers in Dallas, TX by specialty
• Addiction (Substance Use Disorder) Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2021; 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.