Active NPI
Secarra Davida Walton
- Professional Counselor
- Spring, TX
National Provider Identifier
1700641289
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 88834
- Practice address
- 19702 Narvi CT
Spring, TX 77379-1475 - Phone
- (832) 409-4417
- Fax
- (833) 320-8545
- NPI assigned
- Feb 14, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Counselor | 101YS0200X | TX | ||
| Professional Counselor | 101YP2500X | 88834 | TX | Primary |
Addresses
Primary practice location
19702 Narvi CT
Spring, TX 77379-1475
Mailing address
4823 Forest Hurst GLN
Spring, TX 77373-2401
Phone (951) 662-3543
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 88834 | TX | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Restorative Counseling Services | Current | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Mental Health Counselor
- Spring, TX
- NPI 1619657210
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707868800000",
"number": "1700641289",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4823 FOREST HURST GLN",
"city": "SPRING",
"state": "TX",
"postal_code": "773732401",
"telephone_number": "951-662-3543"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19702 NARVI CT",
"city": "SPRING",
"state": "TX",
"postal_code": "773791475",
"telephone_number": "832-409-4417",
"fax_number": "833-320-8545"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALTON",
"first_name": "SECARRA",
"middle_name": "DAVIDA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-02-14",
"last_updated": "2024-02-14",
"certification_date": "2024-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YS0200X",
"taxonomy_group": "",
"desc": "Counselor, School",
"state": "TX",
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "88834",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spring, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.