Active NPI
Michaela Trevino, LCDC, LPC-A
- Professional Counselor
- Lubbock, TX
National Provider Identifier
1558069534
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 89521
- Practice address
- 3601 4TH Street
Lubbock, TX 79430 - Phone
- (806) 414-7372
- NPI assigned
- Feb 20, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 89521 | TX | Primary |
Addresses
Primary practice location
3601 4TH Street
Lubbock, TX 79430
Mailing address
8821 Flint Ave
Lubbock, TX 79423-3015
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 89521 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1676851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719187200000",
"number": "1558069534",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8821 FLINT AVE",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794233015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3601 4TH STREET",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "79430",
"telephone_number": "806-414-7372"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TREVINO",
"first_name": "MICHAELA",
"credential": "LCDC, LPC-A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-02-20",
"last_updated": "2024-06-24",
"certification_date": "2024-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "89521",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lubbock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.