Active NPI
Katie Danielle Edmondson
- Counselor
- Flower Mound, TX
National Provider Identifier
1043789167
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 79959
- Practice address
- 1190 Parker SQ
Flower Mound, TX 75028-7432 - Phone
- (972) 316-9593
- NPI assigned
- Nov 19, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 79959 | TX | Primary |
Addresses
Primary practice location
1190 Parker SQ
Flower Mound, TX 75028-7432
Mailing address
2456 Fort Worth Ave Apt 7304
Dallas, TX 75211-1829
Phone (972) 533-3488
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 |
|---|---|---|---|
| 79959 | TX | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1542585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1542585600000",
"number": "1043789167",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2456 FORT WORTH AVE APT 7304",
"city": "DALLAS",
"state": "TX",
"postal_code": "752111829",
"telephone_number": "972-533-3488"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1190 PARKER SQ",
"city": "FLOWER MOUND",
"state": "TX",
"postal_code": "750287432",
"telephone_number": "972-316-9593"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDMONDSON",
"first_name": "KATIE",
"middle_name": "DANIELLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-11-19",
"last_updated": "2018-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "TX",
"license": "79959",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flower Mound, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.