Individual provider Active NPI

Michael Householder, LCDC

  • Addiction (Substance Use Disorder) Counselor
  • Dallas, TX
National Provider Identifier
1588213854
Registry record updated Sep 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
12987 Issued in TX
Practice address
2010 Al Lipscomb Way
Dallas, TX 75215-2773
Phone
(469) 516-4472
NPI assigned
Sep 9, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 12987 TX Primary

Addresses

Primary practice location

2010 Al Lipscomb Way
Dallas, TX 75215-2773

Mailing address

2010 Al Lipscomb Way
Dallas, TX 75215-2773
Phone (469) 516-4472

Other identifiers 1

IdentifierTypeStateIssuer
399885801MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
12987TXMDSports Physician Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
The Men of Nehemiah Inc. PastSince Sep 15, 2019 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": "1567987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567987200000",
    "number": "1588213854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 AL LIPSCOMB WAY",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752152773",
            "telephone_number": "469-516-4472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 AL LIPSCOMB WAY",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752152773",
            "telephone_number": "469-516-4472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUSEHOLDER",
        "first_name": "MICHAEL",
        "credential": "LCDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-09",
        "last_updated": "2019-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "12987",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "399885801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.