Active NPI
Jerry Lynn Huckabee, M. ED. LPC
- Professional Counselor
- Stephenville, TX
National Provider Identifier
1063464907
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective Oct 20, 2022.
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 17322
- Practice address
- 126 Byron St
Stephenville, TX 76401-4602 - Phone
- (254) 965-5327
- Fax
- (254) 965-5327
- NPI assigned
- May 17, 2006
- Last updated
- Feb 7, 2009
- Sex
- Male
- 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 | 17322 | TX | Primary |
Addresses
Primary practice location
126 Byron St
Stephenville, TX 76401-4602
Mailing address
126 Byron St
Stephenville, TX 76401-4602
Phone (254) 965-5327
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 011459448 | Medicaid | TX |
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17322 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1233964800000",
"number": "1063464907",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "126 BYRON ST",
"city": "STEPHENVILLE",
"state": "TX",
"postal_code": "764014602",
"telephone_number": "254-965-5327",
"fax_number": "254-965-5327"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "126 BYRON ST",
"city": "STEPHENVILLE",
"state": "TX",
"postal_code": "764014602",
"telephone_number": "254-965-5327",
"fax_number": "254-965-5327"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUCKABEE",
"first_name": "JERRY",
"middle_name": "LYNN",
"name_prefix": "Mr.",
"credential": "M. ED. LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-17",
"last_updated": "2009-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "17322",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "011459448",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Stephenville, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.