Individual provider Active NPI

Destinee Manuela Wells

  • Professional Counselor
  • Pearland, TX
National Provider Identifier
1831960566
Registry record updated Feb 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
93524 Issued in TX
Practice address
11601 Shadow Creek Pkwy Ste 111-659
Pearland, TX 77584-7283
Phone
(713) 581-4527
NPI assigned
Jan 11, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Professional Counselor 101YP2500X 93524 TX Primary

Addresses

Primary practice location

11601 Shadow Creek Pkwy Ste 111-659
Pearland, TX 77584-7283

Mailing address

11601 Shadow Creek Pkwy Ste 111-659
Pearland, TX 77584-7283
Phone (713) 581-4527

Other practice location 1

1899 Lake Rd Ste 123
Hiram, GA 30141-6006
Phone (678) 896-8958

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
93524TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Tranquil Life Counseling Center, LLC Mental Health CurrentSince May 7, 2024 Accepting new patients
Aspen Counseling and Wellness, LLC Mental Health CurrentSince Feb 9, 2025 Accepting new patients

Locations

1899 Lake Rd
Ste 123
Hiram, GA 30141
Phone (678) 896-8958

11601 Shadow Creek Pkwy
Ste 111659
Pearland, TX 77584
Phone (713) 581-4527

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": "1704931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1831960566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11601 SHADOW CREEK PKWY STE 111-659",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847283",
            "telephone_number": "713-581-4527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11601 SHADOW CREEK PKWY STE 111-659",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847283",
            "telephone_number": "713-581-4527"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1899 Lake Rd Ste 123",
            "address_purpose": "LOCATION",
            "city": "Hiram",
            "state": "GA",
            "postal_code": "301416006",
            "country_code": "US",
            "telephone_number": "678-896-8958",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WELLS",
        "first_name": "DESTINEE",
        "middle_name": "MANUELA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-11",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "93524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pearland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.