Individual provider Active NPI

Irisdomar Santiago Molina, LMHC

  • Professional Counselor
  • Laredo, TX
National Provider Identifier
1770936346
Registry record updated Jan 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
97146 Issued in TX
Practice address
1500 Pappas St
Laredo, TX 78041-1701
Phone
(956) 794-3000
NPI assigned
Jul 19, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 4770 PR
Mental Health Counselor 101YM0800X MH20222 FL
Professional Counselor 101YP2500X 97146 TX Primary

Addresses

Primary practice location

1500 Pappas St
Laredo, TX 78041-1701

Mailing address

3203 Zander Dr Apt 102
Kissimmee, FL 34747-1178
Phone (407) 300-6548

Other practice location 1

1999 W Colonial Dr
Orlando, FL 32804-7021
Phone (407) 219-9304

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
I20250123001812 TX Practitioner - Mental Health Counselor 0749721637 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Texas Health Virtual CareGroup PAC ID 5991176356, 40 clinicians

Practice addresses (Care Compare)

240 N Miller Rd
Mansfield, TX 76063-5842
Phone (214) 432-8322

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH20222FLMDMental Health Counselor
97146TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Border Region MH Mr Community Center CurrentSince Dec 1, 2024 Accepting new patients
Texas Health Virtual Care CurrentSince Mar 1, 2026 Accepting new patients

Locations

1500 Pappas St
Laredo, TX 78041
Phone (956) 794-3000

240 N Miller Rd
Mansfield, TX 76063
Phone (214) 432-8322

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": "1468886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1770936346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3203 ZANDER DR APT 102",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347471178",
            "telephone_number": "407-300-6548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 PAPPAS ST",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780411701",
            "telephone_number": "956-794-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1999 W Colonial Dr",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328047021",
            "country_code": "US",
            "telephone_number": "407-219-9304",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANTIAGO MOLINA",
        "first_name": "IRISDOMAR",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-19",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "PR",
            "license": "4770",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH20222",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "97146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laredo, TX

Sources for this page

Verify at the official NPI Registry.