Individual provider Active NPI

Kathy A Stan, MA, LPC

  • Professional Counselor
  • Kingwood, TX
National Provider Identifier
1639635691
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
77521 Issued in TX
Practice address
23051 Kingwood Place Dr Ste 110
Kingwood, TX 77339-3962
Phone
(844) 824-8775
NPI assigned
Feb 14, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 77521 TX Primary
Mental Health Counselor 101YM0800X 77521 TX

Addresses

Primary practice location

23051 Kingwood Place Dr Ste 110
Kingwood, TX 77339-3962

Mailing address

23051 Kingwood Place Dr Ste 110
Kingwood, TX 77339-3962
Phone (844) 824-8775

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
I20241023004712 TX Practitioner - Mental Health Counselor 4981137304 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Texas a & M University System, HSC, College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Progressive Behavioral Health, PLLCGroup PAC ID 4486794906, 366 clinicians

Practice addresses (Care Compare)

23051 Kingwood Place Dr
Suite 110
Kingwood, TX 77339-3962
Phone (844) 824-8775

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Progressive Behavioral Health, PLLC Mental Health CurrentSince Oct 1, 2024 Accepting new patients

Locations

12505 Memorial Dr
Ste 230
Houston, TX 77024
Phone (210) 858-9078

23051 Kingwood Place Dr
Ste 110
Kingwood, TX 77339
Phone (281) 374-4500

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1550102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1639635691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23051 KINGWOOD PLACE DR STE 110",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773393962",
            "telephone_number": "844-824-8775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23051 KINGWOOD PLACE DR STE 110",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773393962",
            "telephone_number": "844-824-8775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAN",
        "first_name": "KATHY",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "MA, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-14",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "77521",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "77521",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingwood, TX

Sources for this page

Verify at the official NPI Registry.