Jesse David Pool, LPC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

17282 Issued in TX

Practice address

3611 Soncy, Suite 4a
Amarillo, TX 79119

Phone

(806) 584-5400

Fax

(806) 359-0610

NPI assigned

Jul 20, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407801600000",
    "number": "1063432136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5133 ROYCE DR",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791103010",
            "telephone_number": "806-584-5400",
            "fax_number": "806-359-0610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3611 SONCY, SUITE 4A",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "79119",
            "telephone_number": "806-584-5400",
            "fax_number": "806-359-0610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POOL",
        "first_name": "JESSE",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2014-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "17282",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "17282",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TX",
            "license": "17282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1493348-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gary R. Polk, MD
• David Henry Pollock
• Polster Delong McKinney Group, LLC
• Emmet Polster, PT
• Breann Tnae Pool, ST
• Tonjua Pope, COTA/L
• Whitney D'Lynn Porter, MS/CCC-SLP
• Aileen Yvette Portillo, RBT
• Agnes L Posadas, PTA
• Lisa Posey, M.S. CCC-SLP

• Counselor in Amarillo, TX
• Providers in Amarillo, TX by specialty
• Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.