Adalid Sis, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

69638 Issued in TX

Practice address

3320 S Loop 256
Palestine, TX 75801-6984

Phone

(903) 723-6136

Fax

(903) 586-4234

NPI assigned

Apr 11, 2016

Last updated

Sep 19, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

• Adalid Ontiveros Former name

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

Specialty

Mental Health Counselor

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Anderson Cherokee Community Enrichment ServicesGroup PAC ID 4284718107, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Anderson Cherokee Community Enrichment Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Jacksonville, TX
  • NPI 1710015201
  Medicare reassignment Care Compare group NPD
• Anderson Cherokee Community Enrichment Services

  dba Clinic of Hope

  • General Practice Physician
  • Jacksonville, TX
  • NPI 1114761996
  NPD

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

{
    "created_epoch": "1460332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537315200000",
    "number": "1700240272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 COLLEGE AVE",
            "city": "JACKSONVILLE",
            "state": "TX",
            "postal_code": "757663307",
            "telephone_number": "903-586-5507",
            "fax_number": "903-586-4234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3320 S LOOP 256",
            "city": "PALESTINE",
            "state": "TX",
            "postal_code": "758016984",
            "telephone_number": "903-723-6136",
            "fax_number": "903-586-4234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIS",
        "first_name": "ADALID",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-11",
        "last_updated": "2018-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "69638",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "69638",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LPC LICENSE",
            "identifier": "69638",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ADALID",
            "last_name": "ONTIVEROS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rebecca Taylor Shipley, NP
• Carla Shirley, FNP
• Julia Lace Short, FNP-C
• Rebekah Sharlene Shultz, RN, CNM
• Janice Lea Sikes, D.O.
• Christina Slate, PHARM D
• Kelley Elizabeth Slate, FNP-C
• Jaime Renea Sleziak, FNP
• Adrianne Patrice Smith, MD
• Kelly M Smith, M.ED, LPC-S

• Mental Health Counselor in Palestine, TX
• Providers in Palestine, TX by specialty
• Mental Health Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.