Racheal Samantha Irvin, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

78983 Issued in TX

Practice address

9401 Southwest Fwy
Houston, TX 77074-1407

Phone

(713) 970-7000

NPI assigned

Oct 28, 2019

Last updated

Jun 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Racheal Anderson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sky Suite Therapy Services

  • Professional Counselor
  • Houston, TX
  • NPI 1073282083
  NPD Authorized official

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

{
    "created_epoch": "1572220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1679116164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4919 ORCHARD GARDEN WAY",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770663437",
            "telephone_number": "832-588-3280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9401 SOUTHWEST FWY",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770741407",
            "telephone_number": "713-970-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRVIN",
        "first_name": "RACHEAL",
        "middle_name": "SAMANTHA",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-28",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "78983",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "373188702",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RACHEAL",
            "last_name": "ANDERSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Christabel Iruonagbe
• Irvin J. Saron, M.D., PA
• Marcellus Irvin
• Melodie Irvin, PA
• Pinki Irvin, OT
• Irving J. Fishman MD, PA
• John Irving
• Kelly A. Irving, RN, MSN WOCN
• Sandra Jean Irving, MD
• Irwin S Novak MD PA

• Professional Counselor in Houston, TX
• Providers in Houston, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.