Individual provider Active NPI

Lavaughn Cecil Mosley III

  • Mental Health Counselor
  • Houston, TX
National Provider Identifier
1659847531
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
74554 Issued in TX
Practice address
12340 Jones Rd Ste 290
Houston, TX 77070-3129
Phone
(281) 894-7222
NPI assigned
Oct 18, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 74554 TX Primary

Addresses

Primary practice location

12340 Jones Rd Ste 290
Houston, TX 77070-3129

Mailing address

12340 Jones Rd Ste 290
Houston, TX 77070-3129
Phone (281) 894-7222

Other practice location 1

12238 Queenston Blvd
Houston, TX 77095-5350
Phone (832) 814-2688

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
I20250109000797 TX Practitioner - Mental Health Counselor 9436687167 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
74554TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Deer Oaks Geriatric Services P C Single Specialty CurrentSince Jan 2, 2025 Accepting new patients
Star of Texas Home Health LLC Current Accepting new patients

Locations

7272 Wurzbach Rd
Ste 706
San Antonio, TX 78240
Phone (210) 615-3401

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": "1539820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1659847531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12340 JONES RD STE 290",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770703129",
            "telephone_number": "281-894-7222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12340 JONES RD STE 290",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770703129",
            "telephone_number": "281-894-7222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12238 Queenston Blvd",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770955350",
            "country_code": "US",
            "telephone_number": "832-814-2688",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOSLEY",
        "first_name": "LAVAUGHN",
        "middle_name": "CECIL",
        "name_suffix": "III",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-18",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "74554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.