Individual provider Active NPI

Guadalupe Ruiz

  • Professional Counselor
  • Kingwood, TX
National Provider Identifier
1861167975
Registry record updated Aug 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
86429 Issued in TX
Practice address
2323 Timber Shadows Dr Ste B
Kingwood, TX 77339-2028
Phone
(832) 233-3086
Fax
(832) 415-3050
NPI assigned
Aug 11, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 86429 TX Primary

Addresses

Primary practice location

2323 Timber Shadows Dr Ste B
Kingwood, TX 77339-2028

Mailing address

PO Box 5857
Kingwood, TX 77325-5857
Phone (832) 233-3086

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
I20241007001047 TX Practitioner - Mental Health Counselor 4789115312

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
86429TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Kbccms, LLC Professional CurrentSince Aug 15, 2021 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1628640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1861167975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5857",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773255857",
            "telephone_number": "832-233-3086",
            "fax_number": "832-415-3050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2323 TIMBER SHADOWS DR STE B",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773392028",
            "telephone_number": "832-233-3086",
            "fax_number": "832-415-3050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "GUADALUPE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-11",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "86429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingwood, TX

Sources for this page

Verify at the official NPI Registry.