Active NPI
Elissa Michelle Jeter, LPC
- Professional Counselor
- Midlothian, TX
National Provider Identifier
1003452525
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 78127
- Practice address
- 200 S 14TH St Ste 120
Midlothian, TX 76065-3359 - Phone
- (214) 235-9087
- NPI assigned
- Nov 19, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 78127 | TX | Primary |
Addresses
Primary practice location
200 S 14TH St Ste 120
Midlothian, TX 76065-3359
Mailing address
200 S 14TH St Ste 120
Midlothian, TX 76065-3359
Phone (214) 235-9087
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 78127 | TX | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hillside Counseling LLC | Professional | Past | Accepting new patients |
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.
-
- Professional Counselor
- Burleson, TX
- NPI 1073736864
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1574121600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574121600000",
"number": "1003452525",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 S 14TH ST STE 120",
"city": "MIDLOTHIAN",
"state": "TX",
"postal_code": "760653359",
"telephone_number": "214-235-9087"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 S 14TH ST STE 120",
"city": "MIDLOTHIAN",
"state": "TX",
"postal_code": "760653359",
"telephone_number": "214-235-9087"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JETER",
"first_name": "ELISSA",
"middle_name": "MICHELLE",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-11-19",
"last_updated": "2019-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "78127",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Midlothian, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.