Individual provider Active NPI

Stefanie Bates Mouton, MA, LPC

  • Professional Counselor
  • Magnolia, TX
National Provider Identifier
1871029843
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
77343 Issued in TX
Practice address
8725 Burdekin Rd
Magnolia, TX 77354-4581
Phone
(281) 770-1858
NPI assigned
May 11, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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 77343 TX Primary

Addresses

Primary practice location

8725 Burdekin Rd
Magnolia, TX 77354-4581

Mailing address

8725 Burdekin Rd
Magnolia, TX 77354-4581
Phone (281) 770-1858

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
I20240502003270 TX Practitioner - Mental Health Counselor 1658711981 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Professional CurrentSince Mar 26, 2024 Accepting new patients
Shine Medical Providers PC Past Accepting new patients
Amy Wine Counseling Center, Inc. Past Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

700 Milam St
Ste 1300
Houston, TX 77002
Phone (281) 801-8391

Organizations & group practices 3

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": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1871029843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8725 BURDEKIN RD",
            "city": "MAGNOLIA",
            "state": "TX",
            "postal_code": "773544581",
            "telephone_number": "281-770-1858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8725 BURDEKIN RD",
            "city": "MAGNOLIA",
            "state": "TX",
            "postal_code": "773544581",
            "telephone_number": "281-770-1858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUTON",
        "first_name": "STEFANIE",
        "middle_name": "BATES",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-11",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "77343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Magnolia, TX

Sources for this page

Verify at the official NPI Registry.