Individual provider Active NPI

Melody McKibbin, LMHC, LPC, LPCC, CPC

  • Mental Health Counselor
  • Ector, TX
National Provider Identifier
1790412955
Registry record updated Sep 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
89657 Issued in TX
Practice address
708 N Main St Apt O
Ector, TX 75439-2040
Phone
(903) 698-7455
NPI assigned
Aug 6, 2022
Last updated
Sep 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2025

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

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 39004978A IN
Mental Health Counselor 101YM0800X CP5666-R NV
Mental Health Counselor 101YM0800X LPC-9376 ID
Mental Health Counselor 101YM0800X CTB-2024-0317 NM
Mental Health Counselor 101YM0800X 89657 TX Primary
Mental Health Counselor 101YM0800X LH61500996 WA
Mental Health Counselor 101YM0800X 14055716-6004 UT
Mental Health Counselor 101YM0800X 125140 IA
Mental Health Counselor 101YM0800X BBH-PCLC-LIC-57423 MT

Addresses

Primary practice location

708 N Main St Apt O
Ector, TX 75439-2040

Mailing address

PO Box 1
Ector, TX 75439-0001
Phone (903) 698-7455

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240530004309 WA Practitioner - Mental Health Counselor 5496107344 Reassigns benefits to 1 organization
I20250131001376 TX Practitioner - Mental Health Counselor 5496107344 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

708 N Main St
Apt O
Ector, TX 75439-2040
Phone (903) 698-7455

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
125140IAMDMental Health Counselor
LPC-9376IDMDMental Health Counselor
39004978AINMDMental Health Counselor
BBH-PCLC-LIC-57423MTMDMental Health Counselor
CTB-2024-0317NMMDMental Health Counselor
CP5666-RNVMDMental Health Counselor
14055716-6004UTMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling Cove PLLC CurrentSince Jan 4, 2024 Accepting new patients

Locations

100 N Howard St
Spokane, WA 99201
Phone (206) 201-1163

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1659744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1790412955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1",
            "city": "ECTOR",
            "state": "TX",
            "postal_code": "754390001",
            "telephone_number": "903-698-7455",
            "fax_number": "903-698-7455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 N MAIN ST APT O",
            "city": "ECTOR",
            "state": "TX",
            "postal_code": "754392040",
            "telephone_number": "903-698-7455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKIBBIN",
        "first_name": "MELODY",
        "credential": "LMHC, LPC, LPCC, CPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-06",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39004978A",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NV",
            "license": "CP5666-R",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LPC-9376",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "CTB-2024-0317",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "89657",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH61500996",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "14055716-6004",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "125140",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MT",
            "license": "BBH-PCLC-LIC-57423",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ector, TX

Sources for this page

Verify at the official NPI Registry.