Individual provider Active NPI

Vivian Lee

  • Professional Counselor
  • Dallas, TX
National Provider Identifier
1720639255
Registry record updated Sep 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
85030 Issued in TX
Practice address
14800 Landmark Blvd
Dallas, TX 75254-7565
Phone
(214) 238-9956
NPI assigned
Sep 25, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Addiction (Substance Use Disorder) Counselor 101YA0400X 15208 TX
Professional Counselor 101YP2500X 85030 TX Primary

Addresses

Primary practice location

14800 Landmark Blvd
Dallas, TX 75254-7565

Mailing address

2401 Ohio Dr Apt 1008
Plano, TX 75093-3975
Phone (512) 426-1693

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, TX, CA, CO4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20251204003277 MA Practitioner - Mental Health Counselor 5496248791 Reassigns benefits to 1 organization
I20251205002577 TX Practitioner - Mental Health Counselor 5496248791 Reassigns benefits to 1 organization
I20251208002351 CA Practitioner - Mental Health Counselor 5496248791 Reassigns benefits to 1 organization
I20260508000267 CO Practitioner - Mental Health Counselor 5496248791 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15208TXMDAddiction (Substance Use Disorder) Counselor
85030TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PC Professional CurrentSince Nov 4, 2025 Accepting new patients
Grow Healthcare Group PA Professional CurrentSince Oct 28, 2025 Accepting new patients
Hri Clinics Inc PastSince Sep 1, 2019 Accepting new patients

Locations

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

100 Cambridge St
Fl 14
Boston, MA 02114
Phone (617) 917-2389

700 Milam St
Ste 1300
Houston, TX 77002
Phone (281) 801-8391

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1569369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632441600000",
    "number": "1720639255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 OHIO DR APT 1008",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750933975",
            "telephone_number": "512-426-1693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14800 LANDMARK BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752547565",
            "telephone_number": "214-238-9956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "VIVIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-25",
        "last_updated": "2021-09-24",
        "certification_date": "2021-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "15208",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "85030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.