Mandisha Matthews Mark

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

83922 Issued in TX

Practice address

2306 Guthrie Rd Ste 260H
Garland, TX 75043-5967

Phone

(469) 290-3080

NPI assigned

Dec 17, 2021

Last updated

Dec 17, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Professional, TX

  Medicare reassignment NPD
• Mental Health Specialty Group PA

  dba Rula Health

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  Professional, TX

  Medicare reassignment NPD

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

{
    "created_epoch": "1639699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1982364915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 VIA ALTOS",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751504426",
            "telephone_number": "310-908-1233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2306 GUTHRIE RD STE 260H",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750435967",
            "telephone_number": "469-290-3080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARK",
        "first_name": "MANDISHA",
        "middle_name": "MATTHEWS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-17",
        "last_updated": "2021-12-17",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "83922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Antoine Marc, MD
• Marci Holloway Consulting, Inc.
• Jonathan Francisco Mares, DPT
• Marilyn Personal Care Services, Inc.
• Carmelina Marin, PA-C
• Makayla Marley
• Heather Allene Martin, OTD, OTR
• Nirmala Martin, FNP-C
• Dannya Keyla Martinez Quevedo
• Caitlin Martinez, M.S. CCC-SLP

• Professional Counselor in Garland, TX
• Providers in Garland, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.