CLINTON R GHOLSON LPC
NPI 1457823734
Counselor - Professional in Canyon Lake, TX
About Clinton R Gholson Lpc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CLINTON R GHOLSON LPC (NPI 1457823734) is an individual professional provider in Canyon Lake, Texas, licensed in Texas (77796) and active in the NPI registry since December 2018. He is enrolled in Medicare PECOS and is a graduate of Other (2016).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Clinton R Gholson Lpc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
2Medicare enrollment records show Clinton Gholson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Fair Play, SC 29643
- Reassigned Medicare billing, South Carolina enrollment
- Also billed through NPI 1629843099 (South Carolina)
- 381 clinicians in this Medicare group
Anderson, SC 29621
- Reassigned Medicare billing, South Carolina enrollment
- 45 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 12
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
CANYON LAKE, TX 78133
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Clinton Gholson's NPI number?
The NPI number for Clinton Gholson is 1457823734. It was assigned to this individual provider in the NPPES registry on December 26, 2018.
Where is Clinton Gholson located?
Clinton Gholson practices at 650 Scarbourough, Canyon Lake, TX 78133. The listed phone number is (830) 964-4390.
What is Clinton Gholson's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is Clinton Gholson enrolled in Medicare?
Yes. Clinton Gholson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Clinton Gholson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Clinton Gholson reassigns Medicare benefits to 2 organizations: Anmed Health (Fair Play, SC) and Taral Sharma MD PC (Anderson, SC). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Clinton Gholson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Clinton Gholson accept?
Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina, BlueCross BlueShield of South Carolina and First Choice Next list Clinton Gholson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Clinton Gholson was last updated on December 26, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Clinton R Gholson, LPC · NPI 1457823734
Professional provider in Canyon Lake, Texas. Individual provider, active in the CMS NPPES registry since December 26, 2018.
## Identity
- **NPI:** 1457823734 (Entity type: Individual)
- **Enumerated:** December 26, 2018
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **State license:** 77796 (Texas)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 650 SCARBOUROUGH, Canyon Lake, TX 78133-4529
- **Phone:** (830) 964-4390
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Anmed Health (NPI 1316263007, Fair Play, SC); Taral Sharma MD PC (NPI 1477112597, Anderson, SC) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2016
## Record status
- **NPPES last updated:** December 26, 2018
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Source: [NPI Profile](https://npiprofile.com/npi/1457823734) · Data from the CMS NPPES public registry.