Shacolby J Dedmond, MED, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

82698 Issued in TX

Practice address

24275 Katy Fwy Ste 410
Katy, TX 77494-7267

Phone

(855) 501-1004

Fax

(844) 708-1274

NPI assigned

Nov 1, 2021

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

Electronic endpoints 1

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

Specialty

Mental Health Counselor

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mark David Levine MD Psychiatrists Professional CorporationGroup PAC ID 4880814540, 31 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Education

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mptx.shacolby.dedmond@149977.advancedmd-direct.com

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.

• Mark David Levine, MD Psychiatrists Professional Corporation

  • Psychiatry Physician
  • Frisco, TX
  • NPI 1841626447

  Mental Health

  Medicare reassignment Care Compare group NPD
• Bellaire Ellie Clinic PC

  • Mental Health Counselor
  • Bellaire, TX
  • NPI 1487372132
  Medicare reassignment NPD
• Mindpath Health Texas PLLC

  • Psychiatry Physician
  • Frisco, TX
  • NPI 1073482105

  Mental Health

  Medicare reassignment NPD

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

{
    "created_epoch": "1635724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776384000000",
    "number": "1992460356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3835 N FREEWAY BLVD STE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958341954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24275 KATY FWY STE 410",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774947267",
            "telephone_number": "855-501-1004",
            "fax_number": "844-708-1274"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6300 West Loop S Ste 110",
            "address_purpose": "LOCATION",
            "city": "Bellaire",
            "state": "TX",
            "postal_code": "774012919",
            "country_code": "US",
            "telephone_number": "832-924-0348",
            "fax_number": "832-852-5754",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1160 Dairy Ashford Rd Ste 601",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770793022",
            "country_code": "US",
            "telephone_number": "281-645-5264",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEDMOND",
        "first_name": "SHACOLBY",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "MED, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-01",
        "last_updated": "2026-04-17",
        "certification_date": "2026-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "82698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shacolbydedmond@vibrantsoulcounseling.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "1018 Margate Ct",
            "city": "Pearland",
            "state": "TX",
            "country_code": "US",
            "postal_code": "775842301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Debbie Hull'S Doula Services and Childbirth Education
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• Jada Lynne Decoste
• Roland Deddeh
• Sandra Dee, LMT
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• Jocelyn Kay Deegan, O.D.
• Nicole Defrancesco, FNP-C
• Joshua Chad Defriece, M.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.