MR. JOSEPH ROBERT EATHERLY (LPC) – Professional Counselor, NPI 1720303134
Professional Counselor
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,950 MENTAL HEALTH COUNSELOR in TX
Provider Addresses for MR. JOSEPH ROBERT EATHERLY (LPC)
540 OAK CENTRE DR STE 205
SAN ANTONIO, TX 782584767
Phone: (844) 824-8775
Type: Location
108, West Main Street, Tishomingo, Johnston County, Oklahoma, 73460, United States
TISHOMINGO, OK 734601723
Phone: (580) 371-3019
Fax: (580) 371-0138
Type: Location
108 W Main St
Tishomingo, OK 734601723
Phone: (580) 371-3019
Fax: (580) 371-0138
Type: Location
Stratford Court, Hidden Creek Apartments, Loveland, Hamilton County, Ohio, 45249, United States
STRATFORD, OK 74872
Phone: (580) 320-5633
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-06-03
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20250422000876 | I | Mental Health Counselor | OK | TBD |
| I20250603002228 | I | Mental Health Counselor | TX | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 78258)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Clinical Social Worker | TX | |
| P S Y C H I A T R Y | NY | |
| Clinical Social Worker | TX | |
| Mental Health Counselor | TX | |
| Mental Health Counselor | TX | |
| Mental Health Counselor | TX | |
| P S Y C H I A T R Y | TX | |
| Clinical Psychologist | TX | |
| Nurse Practitioner | MO | |
| Nurse Practitioner | TX |
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