Individual provider Active NPI

Aanchal Rajagopal, MS

  • Professional Counselor
  • Mansfield, TX
National Provider Identifier
1609575455
Registry record updated Mar 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
90918 Issued in TX
Practice address
751 Highway 287 N Ste 103
Mansfield, TX 76063-6604
Phone
(214) 952-2324
Fax
(214) 572-2986
NPI assigned
Mar 1, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2023

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 90918 TX Primary

Addresses

Primary practice location

751 Highway 287 N Ste 103
Mansfield, TX 76063-6604

Mailing address

751 Highway 287 N Ste 103
Mansfield, TX 76063-6604

Other identifiers 1

IdentifierTypeStateIssuer
90918OtherTXLICENSE

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
I20241106000051 TX Practitioner - Mental Health Counselor 5890229454 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

771 E Southlake Blvd
Suite 101
Southlake, TX 76092-1483
Phone (682) 593-1701

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
MD Trucare PA CurrentSince Oct 1, 2024 Accepting new patients
Vitalis Psychotherapy and Counselling LLC Professional CurrentSince Dec 1, 2024 Accepting new patients
Mansfield Counseling Professional PastSince Mar 5, 2023 Accepting new patients

Locations

10640 N Riverside Dr
Ste 300
Fort Worth, TX 76244
Phone (817) 722-6078

823 Ira E Woods Ave
Ste 200
Grapevine, TX 76051
Phone (817) 421-9999

771 E Southlake Blvd
Ste 101
Southlake, TX 76092
Phone (817) 381-9650

515 W Southlake Blvd
Ste 175
Southlake, TX 76092
Phone (682) 593-1701

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AJHDBD

Organizations & group practices 3

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": "1677628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677628800000",
    "number": "1609575455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 HIGHWAY 287 N STE 103",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760636604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 HIGHWAY 287 N STE 103",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760636604",
            "telephone_number": "214-952-2324",
            "fax_number": "214-572-2986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJAGOPAL",
        "first_name": "AANCHAL",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-01",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "90918",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "90918",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, TX

Sources for this page

Verify at the official NPI Registry.