Individual provider Active NPI

Maria Fernanda Melicoff, LPC, LMFT

  • Professional Counselor
  • Houston, TX
National Provider Identifier
1992043947
Registry record updated Mar 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
69059 Issued in TX
Practice address
106 Avondale St
Houston, TX 77006-3314
Phone
(832) 577-0504
NPI assigned
Jan 25, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2024

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 69059 TX Primary

Addresses

Primary practice location

106 Avondale St
Houston, TX 77006-3314

Mailing address

106 Avondale St
Houston, TX 77006-3314
Phone (832) 577-0504

Other practice location 1

13350 Woodforest Blvd
Houston, TX 77015-2826
Phone (832) 548-5000

Other practice location 2

1415 California St
Houston, TX 77006-2602
Phone (832) 548-5000

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
I20240208002805 TX Practitioner - Mental Health Counselor 5496198293

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
69059TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Service Center at Houston and Harris County CurrentSince Oct 1, 2024 Accepting new patients

Locations

4950 Memorial Dr
Houston, TX 77007
Phone (713) 730-2335

411 Durham Dr
Houston, TX 77007
Phone (713) 861-4849

1300 Bay Area Blvd
#240A
Houston, TX 77058
Phone (713) 861-4849

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": "1359072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709769600000",
    "number": "1992043947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 AVONDALE ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770063314",
            "telephone_number": "832-577-0504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 AVONDALE ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770063314",
            "telephone_number": "832-577-0504"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13350 Woodforest Blvd",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770152826",
            "country_code": "US",
            "telephone_number": "832-548-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1415 California St",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770062602",
            "country_code": "US",
            "telephone_number": "832-548-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MELICOFF",
        "first_name": "MARIA",
        "middle_name": "FERNANDA",
        "credential": "LPC, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-25",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "69059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.