Individual provider Active NPI

Chandra Rae Wiginton, LPC, NCC

  • Mental Health Counselor
  • Odessa, TX
National Provider Identifier
1932903937
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
92736 Issued in TX
Practice address
4682 E University Blvd Ste D
Odessa, TX 79762-8190
Phone
(432) 848-6944
NPI assigned
Apr 1, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 1728085
Professional Counselor 101YP2500X 92736 TX
Mental Health Counselor 101YM0800X 92736 TX Primary

Addresses

Primary practice location

4682 E University Blvd Ste D
Odessa, TX 79762-8190

Mailing address

4682 E University Blvd Ste D
Odessa, TX 79762-8190
Phone (432) 848-6944

Other practice location 1

401 E Illinois Ave
Midland, TX 79701-4803
Phone (432) 848-6944

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: No
  • 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
I20250403003850 TX Practitioner - Mental Health Counselor 9133643810 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
92736TXMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Permian Basin Community Centers for Mental Health & Mental Retardation Current Accepting new patients
Permian Basin Community Centers for Mental Health & Mental Retardation CurrentSince Apr 1, 2025 Accepting new patients
Frontline Resilience Collective Mental Health Current Accepting new patients
Permian Basin Community Centers for Mental Health & Mental Retardation CurrentSince Apr 1, 2025 Accepting new patients

Locations

401 E Illinois Ave
Midland, TX 79701
Phone (432) 570-3300

401 E Illinois Ave
Ste 100
Midland, TX 79701
Phone (432) 570-3300

401 E Illinois Ave
Ste 300
Midland, TX 79701
Phone (432) 570-3342

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": "1743465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1932903937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4682 E UNIVERSITY BLVD STE D",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797628190",
            "telephone_number": "432-848-6944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4682 E UNIVERSITY BLVD STE D",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797628190",
            "telephone_number": "432-848-6944"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401 E Illinois Ave",
            "address_purpose": "LOCATION",
            "city": "Midland",
            "state": "TX",
            "postal_code": "797014803",
            "country_code": "US",
            "telephone_number": "432-848-6944",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIGINTON",
        "first_name": "CHANDRA",
        "middle_name": "RAE",
        "credential": "LPC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-01",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": "1728085",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "92736",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "92736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

Verify at the official NPI Registry.