Individual provider Active NPI

Samuel Patrick Fogle, M.S., L.P.C.

  • Addiction (Substance Use Disorder) Counselor
  • Abilene, TX
National Provider Identifier
1790752319
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
16245 Issued in TX
Practice address
1219 E South 11TH St
Suite a
Abilene, TX 79602-4283
Phone
(325) 676-2039
Fax
(325) 480-4784
NPI assigned
Mar 2, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 16245 TX
Addiction (Substance Use Disorder) Counselor 101YA0400X 16245 TX Primary
Mental Health Counselor 101YM0800X 16245 TX
Professional Counselor 101YP2500X 16245 TX

Addresses

Primary practice location

1219 E South 11TH St
Suite a
Abilene, TX 79602-4283

Mailing address

1219 E South 11TH St
Suite a
Abilene, TX 79602-4283
Phone (325) 676-2039

Other identifiers 1

IdentifierTypeStateIssuer
7252LCOtherTXBLUE CROSS & BLUE SHIELD

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
I20240508001479 TX Practitioner - Mental Health Counselor 5799126793 Practice locations: Abilene, TX

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1219 E S 11TH St
Suite a
Abilene, TX 79602-4283
Phone (325) 386-0020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
16245TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
St. Cyr, LLC Professional Past Accepting new patients

Organizations & group practices 1

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": "1141257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1790752319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1219 E SOUTH 11TH ST",
            "address_2": "SUITE A",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796024283",
            "telephone_number": "325-676-2039",
            "fax_number": "325-480-4784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1219 E SOUTH 11TH ST",
            "address_2": "SUITE A",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796024283",
            "telephone_number": "325-676-2039",
            "fax_number": "325-480-4784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOGLE",
        "first_name": "SAMUEL",
        "middle_name": "PATRICK",
        "name_prefix": "Mr.",
        "credential": "M.S., L.P.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-02",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TX",
            "license": "16245",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "16245",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "16245",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "16245",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS & BLUE SHIELD",
            "identifier": "7252LC",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Abilene, TX

Sources for this page

Verify at the official NPI Registry.