Individual provider Active NPI

Cedric Ita Eyo, LPC

  • Professional Counselor
  • Sugar Land, TX
National Provider Identifier
1508349770
Registry record updated Sep 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
75651 Issued in TX
Practice address
14090 Southwest Fwy Ste 300
Sugar Land, TX 77478-3679
Phone
(346) 375-7281
NPI assigned
Sep 12, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2023

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 75651 TX Primary

Addresses

Primary practice location

14090 Southwest Fwy Ste 300
Sugar Land, TX 77478-3679

Mailing address

2526 Business Center Dr Apt 913
Pearland, TX 77584-2433
Phone (832) 775-6416

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
I20240111004360 TX Practitioner - Mental Health Counselor 7810382512 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
75651TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Solid Trails Counseling and Consulting PLLC CurrentSince Mar 4, 2022 Accepting new patients

Locations

14090 Southwest Fwy
Ste 300
Sugar Land, TX 77478
Phone (346) 433-1579

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1536710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694131200000",
    "number": "1508349770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2526 BUSINESS CENTER DR APT 913",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775842433",
            "telephone_number": "832-775-6416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14090 SOUTHWEST FWY STE 300",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774783679",
            "telephone_number": "346-375-7281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EYO",
        "first_name": "CEDRIC",
        "middle_name": "ITA",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-12",
        "last_updated": "2023-09-08",
        "certification_date": "2023-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "75651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sugar Land, TX

Sources for this page

Verify at the official NPI Registry.