Individual provider Active NPI

Kathryn Ann Poe, M.A., LPC

  • Professional Counselor
  • Irving, TX
National Provider Identifier
1669819504
Registry record updated Sep 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
67628 Issued in TX
Practice address
3661 W Walnut Hill LN
Apartment 2148
Irving, TX 75038-4044
Phone
(432) 260-6379
NPI assigned
Jun 2, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 67628 TX
Professional Counselor 101YP2500X 67628 TX Primary

Addresses

Primary practice location

3661 W Walnut Hill LN
Apartment 2148
Irving, TX 75038-4044

Mailing address

551 Golden Grove Pkwy
San Marcos, TX 78666-4578
Phone (432) 260-6379

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
I20260605000282 TX Practitioner - Mental Health Counselor 9032680517 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2010
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

17503 La Cantera Pkwy
Suite 104
San Antonio, TX 78257-4000

PO Box
Suite 186859
Hamden, CT 06518

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
67628TXMDMental Health Counselor

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": "1370131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632355200000",
    "number": "1669819504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "551 GOLDEN GROVE PKWY",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786664578",
            "telephone_number": "432-260-6379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3661 W WALNUT HILL LN",
            "address_2": "APARTMENT 2148",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750384044",
            "telephone_number": "432-260-6379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POE",
        "first_name": "KATHRYN",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "M.A., LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-02",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "67628",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "67628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

Verify at the official NPI Registry.