Individual provider Active NPI

Phuong Madalena Luu

  • Mental Health Counselor
  • Alvin, TX
National Provider Identifier
1528694635
Registry record updated Feb 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
79985 Issued in TX
Practice address
1111 W Adoue St
Alvin, TX 77511-2718
Phone
(281) 824-1480
Fax
(281) 220-6407
NPI assigned
Mar 20, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 79985 TX
Mental Health Counselor 101YM0800X 79985 TX Primary

Addresses

Primary practice location

1111 W Adoue St
Alvin, TX 77511-2718

Mailing address

1111 W Adoue St
Alvin, TX 77511-2718
Phone (281) 824-1480

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
I20241105000016 TX Practitioner - Mental Health Counselor 7517490196 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stephen F Austin Community Health Center, Inc.Group PAC ID 6204977127, 95 clinicians

Practice addresses (Care Compare)

1111 W Adoue St
Alvin, TX 77511-2718
Phone 28182414801594

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
79985TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Stephen F. Austin Community Health Center, Inc. CurrentSince Aug 23, 2024 Accepting new patients
Stephen F Austin Community Health Center,Inc CurrentSince Aug 23, 2024 Accepting new patients

Locations

1111 W Adoue St
Alvin, TX 77511
Phone 2818241480 ext. 1594

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1584662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646006400000",
    "number": "1528694635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 W ADOUE ST",
            "city": "ALVIN",
            "state": "TX",
            "postal_code": "775112718",
            "telephone_number": "281-824-1480",
            "fax_number": "281-220-6407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 W ADOUE ST",
            "city": "ALVIN",
            "state": "TX",
            "postal_code": "775112718",
            "telephone_number": "281-824-1480",
            "fax_number": "281-220-6407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUU",
        "first_name": "PHUONG",
        "middle_name": "MADALENA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-20",
        "last_updated": "2022-02-28",
        "certification_date": "2022-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "79985",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "79985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alvin, TX

Sources for this page

Verify at the official NPI Registry.