Individual provider Active NPI

Peter Kariuki Mburu, LLPC

  • Professional Counselor
  • Dallas, TX
National Provider Identifier
1922384544
Registry record updated Apr 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401012614 Issued in MI
Practice address
3330 S Lancaster Rd
Dallas, TX 75216-4531
Phone
(214) 743-1200
NPI assigned
Oct 27, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2022

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 6401012614 MI Primary

Addresses

Primary practice location

3330 S Lancaster Rd
Dallas, TX 75216-4531

Mailing address

100 Cherry Street, S.E
Cherry Street Health Services
Grand Rapids, MI 49503
Phone (616) 965-8200

Other practice location 1

40 Jefferson Ave SE
Grand Rapids, MI 49503-4304
Phone (866) 271-6796

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
I20240213002919 TX Practitioner - Mental Health Counselor 9133562515 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dallas County Hospital DistrictGroup PAC ID 8325934813, 597 clinicians

Practice addresses (Care Compare)

801 Conover Dr
Grand Prairie, TX 75051-1519
Phone (214) 266-3500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6401012614MIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas County Hospital District CurrentSince Jan 2, 2024 Accepting new patients
Dallas County Hospital District Current Accepting new patients
Dallas County Hospital District CurrentSince Jan 2, 2024 Accepting new patients
Amazing Counseling and Rehabilitation Services, Incorporated Professional Past Accepting new patients

Locations

801 Conover Dr
Grand Prairie, TX 75051
Phone (214) 266-3400

1800 N Britain Rd
Irving, TX 75061
Phone (214) 266-3000

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": "1319673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649116800000",
    "number": "1922384544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CHERRY STREET, S.E",
            "address_2": "CHERRY STREET HEALTH SERVICES",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49503",
            "telephone_number": "616-965-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 S LANCASTER RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752164531",
            "telephone_number": "214-743-1200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "40 Jefferson Ave SE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495034304",
            "country_code": "US",
            "telephone_number": "866-271-6796",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MBURU",
        "first_name": "PETER",
        "middle_name": "KARIUKI",
        "credential": "LLPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-10-27",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401012614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.