KEVIN MACK (LPC) – Professional Counselor, NPI 1972144392

KEVIN MACK (LPC) is a healthcare provider. based in Stafford, Texas. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials LPC. They hold a License No. 82836 (TX). The NPI Number for KEVIN MACK (LPC) is 1972144392

Main info

Male
Sole Proprietor
18 Years Of Experience
Accepts Medicare Assignment
Name
KEVIN MACK (LPC)
NPI
1972144392
Phone
(281) 571-1734
Address
638 BOLD RULER DR
Enumeration Date
7 October 2019
Last Update Date
18 June 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3462798175
Graduation Year
2008 (18 years ago)
PAC ID
2264968163
Group Practice PAC ID
0446786347
Professional Enrollment ID
I20241213003567
Address ID
TX770742089HO7322XFWYX301

Contacts

Main Contact
kmacksu@yahoo.com
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience46
Completeness85
Years active:6State licenses:1Other namesUpdated within 12 months

3,950 MENTAL HEALTH COUNSELOR in TX

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Provider Addresses for KEVIN MACK (LPC)

  • 638, Bold Ruler Drive, Stafford, Fort Bend County, Texas, 77477, United States

    STAFFORD, TX 774776354

    Phone: (281) 571-1734

    Type: Mailing

  • 7322 SOUTHWEST FWY STE 1055

    HOUSTON, TX 770742089

    Phone: (462) 798-1753

    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: 2024-12-13

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20241213003567IMental Health CounselorTXTBD

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.

Verify on CMS Revalidation Lookup Tool

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 77477)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0446786347View full group profile
NameSpecialtyState
Mental Health CounselorTX

Reviews

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Frequently asked questions

What is the registry number for KEVIN MACK (LPC)?
The registry entry for KEVIN MACK (LPC) shows NPI 1972144392.
Should I treat KEVIN MACK (LPC) as an active provider?
Patients and plans typically see KEVIN MACK (LPC) as active in the national extract.
What does the directory say KEVIN MACK (LPC) does?
Insurance directories may phrase it differently, but here KEVIN MACK (LPC) maps to Professional Counselor. Clinical services aligned with this taxonomy classification.
What geographic area is tied to KEVIN MACK (LPC)?
KEVIN MACK (LPC) is associated with Stafford, Texas in the same public data insurers reference.
Can I export KEVIN MACK (LPC)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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