Active NPI
Roger K Hancock, LPC
- Professional Counselor
- Odessa, TX
National Provider Identifier
1902589534
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 79729
- Practice address
- 4803 Plaza Blvd Ste 401
Odessa, TX 79762-4916 - Phone
- (432) 214-7699
- NPI assigned
- Aug 10, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 79729 | TX | Primary |
Addresses
Primary practice location
4803 Plaza Blvd Ste 401
Odessa, TX 79762-4916
Mailing address
18600 SCR 1357
Odessa, TX 79766
Phone (432) 214-7699
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
| License | State | Type | Specialty |
|---|---|---|---|
| 79729 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1691625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691625600000",
"number": "1902589534",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18600 SCR 1357",
"city": "ODESSA",
"state": "TX",
"postal_code": "79766",
"telephone_number": "432-214-7699"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4803 PLAZA BLVD STE 401",
"city": "ODESSA",
"state": "TX",
"postal_code": "797624916",
"telephone_number": "432-214-7699"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANCOCK",
"first_name": "ROGER",
"middle_name": "K",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-08-10",
"last_updated": "2023-08-10",
"certification_date": "2023-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "79729",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Odessa, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.