Individual provider Active NPI

Teresa Lynn Pace, PH.D., M.ED., LPC

  • Professional Counselor
  • The Woodlands, TX
National Provider Identifier
1568136885
Registry record updated Oct 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
18996 Issued in AZ
Practice address
1610 Woodstead CT Ste 420
The Woodlands, TX 77380-3404
Phone
(281) 363-4220
NPI assigned
Aug 2, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2022

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 18996 AZ Primary

Addresses

Primary practice location

1610 Woodstead CT Ste 420
The Woodlands, TX 77380-3404

Mailing address

3513 Korina Way
Conroe, TX 77306-5021
Phone (936) 828-1778

Other practice location 1

11376 S Coolwater Dr
Goodyear, AZ 85338-9538
Phone (936) 828-1778

Other practice location 2

3513 Korina Way
Conroe, TX 77306-5021
Phone (936) 828-1778

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Apr 26, 2024 through Apr 26, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Education, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
18996AZMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Woodlands Family Institute, PC PastSince Oct 16, 2022 Accepting new patients

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, 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": "1627862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665273600000",
    "number": "1568136885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3513 KORINA WAY",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773065021",
            "telephone_number": "936-828-1778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 WOODSTEAD CT STE 420",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773803404",
            "telephone_number": "281-363-4220"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11376 S Coolwater Dr",
            "address_purpose": "LOCATION",
            "city": "Goodyear",
            "state": "AZ",
            "postal_code": "853389538",
            "country_code": "US",
            "telephone_number": "936-828-1778",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3513 Korina Way",
            "address_purpose": "LOCATION",
            "city": "Conroe",
            "state": "TX",
            "postal_code": "773065021",
            "country_code": "US",
            "telephone_number": "936-828-1778",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PACE",
        "first_name": "TERESA",
        "middle_name": "LYNN",
        "credential": "PH.D., M.ED., LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-02",
        "last_updated": "2022-10-09",
        "certification_date": "2022-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "18996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in The Woodlands, TX

Sources for this page

Verify at the official NPI Registry.