Individual provider Active NPI

Paul E Blankenship, LPC

  • Professional Counselor
  • Fort Worth, TX
National Provider Identifier
1972096832
Registry record updated Jun 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
75519 Issued in TX
Practice address
3200 Sanguinet St
Fort Worth, TX 76107-5355
Phone
(817) 255-2652
Fax
(817) 255-2657
NPI assigned
Jun 14, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 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 75519 TX Primary

Addresses

Primary practice location

3200 Sanguinet St
Fort Worth, TX 76107-5355

Mailing address

3200 Sanguinet St
Fort Worth, TX 76107-5355
Phone (817) 255-2652

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
I20240416002651 TX Practitioner - Mental Health Counselor 6002255643 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lena Pope Home, Inc.Group PAC ID 0143230631, 10 clinicians

Practice addresses (Care Compare)

3200 Sanguinet St
Fort Worth, TX 76107-5355
Phone (817) 255-2652

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lena Pope Home, Inc. Professional CurrentSince Mar 12, 2024 Accepting new patients

Locations

3200 Sanguinet St
Fort Worth, TX 76107
Phone (817) 255-2500

Organizations & group practices 1

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": "1528934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528934400000",
    "number": "1972096832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 SANGUINET ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761075355",
            "telephone_number": "817-255-2652",
            "fax_number": "817-255-2657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 SANGUINET ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761075355",
            "telephone_number": "817-255-2652",
            "fax_number": "817-255-2657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANKENSHIP",
        "first_name": "PAUL",
        "middle_name": "E",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-14",
        "last_updated": "2018-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "75519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.