Individual provider Active NPI

Leah Anne Fowlkes-Miller, MA

  • Professional Counselor
  • El Paso, TX
National Provider Identifier
1760524938
Registry record updated Jul 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
15604 Issued in TX
Practice address
300 Thunderbird Dr
Suite 12
El Paso, TX 79912-3832
Phone
(915) 845-3122
Fax
(915) 845-4165
NPI assigned
Feb 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 15604 TX Primary
Marriage & Family Therapist 106H00000X 4905 TX

Addresses

Primary practice location

300 Thunderbird Dr
Suite 12
El Paso, TX 79912-3832

Mailing address

300 Thunderbird Dr
Suite 12
El Paso, TX 79912-3832
Phone (915) 845-3122

Other identifiers 1

IdentifierTypeStateIssuer
028024002MedicaidTX

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
I20240126001842 TX Practitioner - Mental Health Counselor 8224313655 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
El Paso Counseling Center of Expressive Arts PCGroup PAC ID 2466736863, 6 clinicians

Practice addresses (Care Compare)

1600 Medical Ctr Dr
Suite B 1
El Paso, TX 79902-5002
Phone (915) 845-3122

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15604TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
El Paso Counseling Center of Expressive Arts PC Professional CurrentSince Jan 27, 2005 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214870400000",
    "number": "1760524938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 THUNDERBIRD DR",
            "address_2": "SUITE 12",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799123832",
            "telephone_number": "915-845-3122",
            "fax_number": "915-845-4165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 THUNDERBIRD DR",
            "address_2": "SUITE 12",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799123832",
            "telephone_number": "915-845-3122",
            "fax_number": "915-845-4165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOWLKES-MILLER",
        "first_name": "LEAH",
        "middle_name": "ANNE",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2008-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "15604",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "4905",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "028024002",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.