Samuel Mitton

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

88003 Issued in TX

Practice address

2853 Crockett St Apt 307
Fort Worth, TX 76107-2993

Phone

(940) 367-1471

NPI assigned

Jun 21, 2018

Reactivated

Jun 29, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Heather D Perez LPC PLLCGroup PAC ID 9133568488, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Heather D Perez LPC PLLC

  dba Mindful Solutions Counseling

  • Mental Health Counselor
  • Fort Worth, TX
  • NPI 1851883961
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1529539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1598259558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2853 CROCKETT ST APT 307",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761072993",
            "telephone_number": "940-367-1471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2853 CROCKETT ST APT 307",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761072993",
            "telephone_number": "940-367-1471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITTON",
        "first_name": "SAMUEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-21",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "deactivation_date": "2023-06-11",
        "reactivation_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "88003",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Jamali Mitchell, MD
• William Horace Mitchell, M.D.
• Taanadeeba Mitee, FNP-BC
• Swati Mittal, D.D.S.
• Matthew Anthony Mittelbronn, MD
• Salma Mitwan
• David William Mize
• Terry Mizell, LPC
• Kimberly Phillips Mizener, FNP
• Adin William Mizer, MD

• Mental Health Counselor in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Mental Health Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.