Individual provider Active NPI

Essica Pullam, LPC

  • Professional Counselor
  • Mansfield, TX
National Provider Identifier
1861065765
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
79451 Issued in TX
Practice address
2363 U.S. 287 Frontage Rd
210
Mansfield, TX 76063
Phone
(214) 702-1518
NPI assigned
Jul 20, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Professional Counselor 101YP2500X 79451 TX Primary

Addresses

Primary practice location

2363 U.S. 287 Frontage Rd
210
Mansfield, TX 76063

Mailing address

990 Highway 287 N Ste 106
Mansfield, TX 76063-2643
Phone (214) 702-1518

Other practice location 1

801 W Lonesome Dove Trl
Arlington, TX 76001-6132
Phone (214) 632-2215

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Theranest.com

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
I20240930000802 TX Practitioner - Mental Health Counselor 6103282272 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Advance Behavioral HealthGroup PAC ID 5991014391, 6 clinicians

Practice addresses (Care Compare)

715 N Fielder Rd
Arlington, TX 76012-4695

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
As I Am Counseling, LLC Professional CurrentSince Jul 1, 2021 Accepting new patients
Texas Advance Behavioral Health CurrentSince Jan 1, 2024 Accepting new patients
Vcounselors PLLC Professional PastSince May 16, 2022 Accepting new patients

Locations

715 N Fielder Rd
#B
Arlington, TX 76012
Phone (682) 220-9615

715 N Fielder Rd
Ste B
Arlington, TX 76012
Phone (682) 220-9615

990 Highway 287 N
Ste 106
Mansfield, TX 76063
Phone (318) 560-5417

Organizations & group practices 4

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": "1626739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1861065765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 HIGHWAY 287 N STE 106",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760632643",
            "telephone_number": "214-702-1518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2363 U.S. 287 FRONTAGE RD",
            "address_2": "210",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "76063",
            "telephone_number": "214-702-1518"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 W Lonesome Dove Trl",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "TX",
            "postal_code": "760016132",
            "country_code": "US",
            "telephone_number": "214-632-2215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PULLAM",
        "first_name": "ESSICA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-20",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "79451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Theranest.com",
            "affiliation": "N",
            "endpointDescription": "Theranest",
            "address_1": "801 W Lonesome Dove Trl",
            "city": "Arlington",
            "state": "TX",
            "country_code": "US",
            "postal_code": "760016132",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mansfield, TX

Sources for this page

Verify at the official NPI Registry.