Clint Ross
Individual provider Active NPI Professional Counselor · China Spring, TX
NPI 1770286296 · NPPES record last updated Mar 23, 2023
Key facts
- NPI
- 1770286296
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 83229 (TX)
- Practice address
- 14038 China Spring Rd # 13
China Spring, TX 76633-3450 - Phone
- (512) 334-6449
- Fax
- (512) 212-7470
- NPI assigned
- Mar 23, 2023
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Connection to Recovery LLC
Redefine LLC
Practice addresses (Care Compare)
14038 China Spring Rd
Suite 13
China Spring, TX 76633-3450
Phone (512) 334-6449
620 Stoneglen Dr
Suite B
Keller, TX 76248-3625
Phone (817) 562-8800
67 Eastern Ave
Suite 302
Saint Johnsbury, VT 05819-5642
Phone (512) 334-6449
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TX, VT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240416002426 | TX | Practitioner - Mental Health Counselor | 4789023326 | Reassigns benefits to 2 organizations |
| I20260511001561 | VT | Practitioner - Mental Health Counselor | 4789023326 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 83229 | TX | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frinz Care LLC | Professional | Current |
Accepting new patients |
| Redefine LLC | Current |
Accepting new patients | |
| Connection to Recovery, LLC | Current |
Accepting new patients |
Locations
14038 China Spring Rd
Ste 13
China Spring, TX 76633
14038 China Spring Rd
#13
China Spring, TX 76633
Phone (512) 334-6449
620 Stoneglen Dr
Ste B
Keller, TX 76248
Phone (817) 562-8800
67 Eastern Ave
Ste 302
St Johnsbury, VT 05819
Phone (512) 334-6449
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 83229 | TX | Yes |
Addresses
Primary practice location
14038 China Spring Rd # 13
China Spring, TX 76633-3450
Mailing address
14038 China Spring Rd # 13
China Spring, TX 76633-3450
Phone (512) 334-6449
Other providers in China Spring, TX
- Nurtiva LLC
- On Call Solution, P.L.L.C.
- Matthew Edward Panter
- Kiana G Perez
- Christy Lynn Repp
- Marla Kay Sanders
- Maria Tillinghast
- Anne Trevino
All providers in China Spring, TX · Professional Counselor in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 23, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.