Individual provider Active NPI

Moran Baxter, LPC-I

  • Mental Health Counselor
  • Dallas, TX
National Provider Identifier
1922657188
Registry record updated Sep 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
82417
Practice address
4100 Spring Valley Rd Ste 515
Dallas, TX 75244-3803
Phone
(817) 751-7802
Fax
(847) 859-5885
NPI assigned
Sep 10, 2019
Last updated
Sep 10, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 82417 Primary

Addresses

Primary practice location

4100 Spring Valley Rd Ste 515
Dallas, TX 75244-3803

Mailing address

175 E Hawthorn Pkwy Ste 235
Vernon Hills, IL 60061-1454
Phone (847) 737-8768

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

NPI Registry JSON

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

{
    "created_epoch": "1568073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568073600000",
    "number": "1922657188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 E HAWTHORN PKWY STE 235",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600611454",
            "telephone_number": "847-737-8768",
            "fax_number": "847-859-5885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 SPRING VALLEY RD STE 515",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752443803",
            "telephone_number": "817-751-7802",
            "fax_number": "847-859-5885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAXTER",
        "first_name": "MORAN",
        "credential": "LPC-I",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-10",
        "last_updated": "2019-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": "82417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.