Active NPI
Carolyn Rodriguez Neisius, LPC
- Counselor
- N Richland Hills, TX
National Provider Identifier
1619638608
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 68073
- Practice address
- 8813 N Tarrant Pkwy Ste 205
N Richland Hills, TX 76182-8461 - Phone
- (682) 328-3458
- NPI assigned
- Jan 3, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 68073 | TX | Primary |
Addresses
Primary practice location
8813 N Tarrant Pkwy Ste 205
N Richland Hills, TX 76182-8461
Mailing address
2503 Kings CT
Colleyville, TX 76034-5056
Phone (682) 328-3458
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective May 17, 2024 through May 17, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 68073 | TX | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1641168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641168000000",
"number": "1619638608",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2503 KINGS CT",
"city": "COLLEYVILLE",
"state": "TX",
"postal_code": "760345056",
"telephone_number": "682-328-3458"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8813 N TARRANT PKWY STE 205",
"city": "N RICHLAND HILLS",
"state": "TX",
"postal_code": "761828461",
"telephone_number": "682-328-3458"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEISIUS",
"first_name": "CAROLYN",
"middle_name": "RODRIGUEZ",
"name_prefix": "Ms.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-01-03",
"last_updated": "2022-01-03",
"certification_date": "2022-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "TX",
"license": "68073",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in N Richland Hills, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.