Active NPI
Dora Ann Whiteside, EDD, LCDC, LPC
- Professional Counselor
- Houston, TX
National Provider Identifier
1780965434
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 62636
- Practice address
- 6410 Marston River LN
Houston, TX 77066-3421 - Phone
- (713) 409-6524
- NPI assigned
- Sep 7, 2011
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 9818 | TX | |
| Professional Counselor | 101YP2500X | 62636 | TX | Primary |
Addresses
Primary practice location
6410 Marston River LN
Houston, TX 77066-3421
Mailing address
6410 Marston River LN
Houston, TX 77066-3421
Phone (713) 409-6524
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 62636 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315353600000",
"number": "1780965434",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6410 MARSTON RIVER LN",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770663421",
"telephone_number": "713-409-6524"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6410 MARSTON RIVER LN",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770663421",
"telephone_number": "713-409-6524"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITESIDE",
"first_name": "DORA",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "EDD, LCDC, LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-09-07",
"last_updated": "2011-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "TX",
"license": "9818",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "62636",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.