Individual provider Active NPI

Serintha Breland

  • Addiction (Substance Use Disorder) Counselor
  • Pearland, TX
National Provider Identifier
1790103760
Registry record updated Jun 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
17492 Issued in TX
Practice address
2913 Birch Bough St
Pearland, TX 77581-5917
Phone
(281) 546-6608
NPI assigned
Apr 7, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 17492 TX Primary

Addresses

Primary practice location

2913 Birch Bough St
Pearland, TX 77581-5917

Mailing address

2913 Birch Bough St
Pearland, TX 77581-5917
Phone (281) 546-6608

Other practice location 1

1213 Durham Dr
Houston, TX 77007-5409
Phone (713) 636-3891

Other identifiers 1

IdentifierTypeStateIssuer
1000015MedicaidTX

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
I20260403000638 TX Practitioner - Mental Health Counselor 1557846870 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2013
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

825 Watters Creek Blvd
Suite 250
Allen, TX 75013-3770

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17492TXMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Horizon Counseling, LLC Current Accepting new patients

Organizations & group practices 2

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": "1396828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1790103760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2913 BIRCH BOUGH ST",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775815917",
            "telephone_number": "281-546-6608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2913 BIRCH BOUGH ST",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775815917",
            "telephone_number": "281-546-6608"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1213 Durham Dr",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770075409",
            "country_code": "US",
            "telephone_number": "713-636-3891",
            "fax_number": "281-888-6510",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRELAND",
        "first_name": "SERINTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-07",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "17492",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000015",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pearland, TX

Sources for this page

Verify at the official NPI Registry.