Individual provider Active NPI

Niloofar Tavakoli, PHD

  • Counseling Psychologist
  • Houston, TX
National Provider Identifier
1679163885
Registry record updated Oct 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
40530 Issued in TX
Practice address
9545 Katy Fwy Ste 425
Houston, TX 77024-1471
Phone
(713) 628-3966
NPI assigned
Jan 21, 2021
Last updated
Oct 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 40530 TX Primary

Addresses

Primary practice location

9545 Katy Fwy Ste 425
Houston, TX 77024-1471

Mailing address

11211 Katy Fwy Ste 300
Houston, TX 77079-2122
Phone (713) 628-3966

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
I20260107002146 TX Practitioner - Clinical Psychologist 6800372160 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2450 Fondren Rd
Suite 312
Houston, TX 77063-2316

314 Furlong Trce
Versailles, KY 40383-2067

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
40530TXMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
CPF SJN Outpatient, LLC Professional CurrentSince Dec 11, 2025 Accepting new patients
Malaty Therapy PastSince Jan 24, 2021 Accepting new patients

Locations

2450 Fondren Rd
Ste 312
Houston, TX 77063
Phone (713) 914-0277

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1611187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759795200000",
    "number": "1679163885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11211 KATY FWY STE 300",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770792122",
            "telephone_number": "713-628-3966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9545 KATY FWY STE 425",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770241471",
            "telephone_number": "713-628-3966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVAKOLI",
        "first_name": "NILOOFAR",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-21",
        "last_updated": "2025-10-07",
        "certification_date": "2025-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "TX",
            "license": "40530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.