Individual provider Active NPI

Obetta Milo, MED, LPC, LCDC

  • Professional Counselor
  • Beaumont, TX
National Provider Identifier
1700382405
Registry record updated Dec 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
74238 Issued in TX
Practice address
2750 S 8TH St
Beaumont, TX 77701-7719
Phone
(409) 839-1000
NPI assigned
Apr 2, 2018
Last updated
Dec 8, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 13047 TX
Mental Health Counselor 101YM0800X 74238 TX
Professional Counselor 101YP2500X 74238 TX Primary

Addresses

Primary practice location

2750 S 8TH St
Beaumont, TX 77701-7719

Mailing address

4048 3Rd St
Port Arthur, TX 77642-3243
Phone (409) 983-4134

Other identifiers 1

IdentifierTypeStateIssuer
13047OtherTXLICENSED CHEMICAL DEPENDENCY COUNSELOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13047TXMDChiropractor
74238TXMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1522627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701993600000",
    "number": "1700382405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4048 3RD ST",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "776423243",
            "telephone_number": "409-983-4134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 S 8TH ST",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777017719",
            "telephone_number": "409-839-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILO",
        "first_name": "OBETTA",
        "credential": "MED, LPC, LCDC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-02",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "13047",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "74238",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "74238",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED CHEMICAL DEPENDENCY COUNSELOR",
            "identifier": "13047",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

Verify at the official NPI Registry.