Individual provider Active NPI

Josi Moon Lauritzen, LPC, LCDC

  • Professional Counselor
  • Richardson, TX
National Provider Identifier
1871085118
Registry record updated Jun 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
72556 Issued in TX
Practice address
605 Cliffside Dr
Richardson, TX 75080-6917
Phone
(972) 741-7548
Fax
(469) 206-7227
NPI assigned
Jun 2, 2018
Last updated
Jun 2, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2018

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 72556 TX Primary

Addresses

Primary practice location

605 Cliffside Dr
Richardson, TX 75080-6917

Mailing address

605 Cliffside Dr
Richardson, TX 75080-6917
Phone (972) 741-7548

Other practice location 1

1113 Hampshire Ln
Richardson, TX 75080-4306
Phone (214) 277-3676

Other identifiers 1

IdentifierTypeStateIssuer
1275984684OtherTXNPI

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
I20240821001543 TX Practitioner - Mental Health Counselor 4486192408 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
72556TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Family and Child Guidance Centers CurrentSince Jun 2, 2024 Accepting new patients
Family and Child Guidance Centers Professional CurrentSince Jun 2, 2024 Accepting new patients

Locations

319 N 12th St
Corsicana, TX 75110
Phone (214) 515-4900

8915 Harry Hines Blvd
Dallas, TX 75235
Phone (972) 548-9484

108 N Washington St
Kaufman, TX 75142

120 W Main St
Ste 220
Mesquite, TX 75149
Phone (469) 397-8119

4031 W Plano Pkwy
Ste 211
Plano, TX 75093
Phone (972) 369-8990

1505 W Jefferson St
Ste 120
Waxahachie, TX 75165
Phone (972) 937-8309

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, 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": "1527897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527897600000",
    "number": "1871085118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 CLIFFSIDE DR",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750806917",
            "telephone_number": "972-741-7548",
            "fax_number": "469-206-7227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 CLIFFSIDE DR",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750806917",
            "telephone_number": "972-741-7548",
            "fax_number": "469-206-7227"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1113 Hampshire Ln",
            "address_purpose": "LOCATION",
            "city": "Richardson",
            "state": "TX",
            "postal_code": "750804306",
            "country_code": "US",
            "telephone_number": "214-277-3676",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAURITZEN",
        "first_name": "JOSI",
        "middle_name": "MOON",
        "name_prefix": "Mrs.",
        "credential": "LPC, LCDC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-02",
        "last_updated": "2018-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "72556",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1275984684",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richardson, TX

Sources for this page

Verify at the official NPI Registry.