Active NPI
Ahrielle Jackson
- Mental Health Counselor
- Fort Worth, TX
National Provider Identifier
1083233316
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 68117
- Practice address
- 5341 Threshing Dr
Fort Worth, TX 76179-8147 - Phone
- (910) 545-4189
- NPI assigned
- Apr 16, 2020
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 68117 | TX | |
| Mental Health Counselor | 101YM0800X | 68117 | TX | Primary |
Addresses
Primary practice location
5341 Threshing Dr
Fort Worth, TX 76179-8147
Mailing address
700 Smith St # 61070
Houston, TX 77002-2714
Phone (817) 369-5528
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 |
|---|---|---|---|
| 68117 | TX | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ahrielle Jackson, PLLC | Mental Health | Current | Accepting new patients |
Locations
700 Smith St
#61070
Houston, TX 77002
Phone (248) 636-1884
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723420800000",
"number": "1083233316",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 SMITH ST # 61070",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770022714",
"telephone_number": "817-369-5528"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5341 THRESHING DR",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761798147",
"telephone_number": "910-545-4189"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "AHRIELLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-04-16",
"last_updated": "2024-08-12",
"certification_date": "2024-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "TX",
"license": "68117",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "68117",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.