Organization Active NPI

Texarkana Mental Health and Wellness Center PLLC

  • Professional Counselor
  • Texarkana, TX
National Provider Identifier
1093349581
Registry record updated Mar 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
TEXARKANA MENTAL HEALTH AND WELLNESS CENTER PLLC
Practice address
4140 McKnight Rd
Texarkana, TX 75503-0921
Phone
(903) 824-2624
NPI assigned
Feb 24, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2020

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

Authorized official

Name
Mrs. Jennifer Michelle Sellers, LPC-SNPI 1841629581
Title
Licensed Profession Counselor
Phone
(903) 824-2624

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

4140 McKnight Rd
Texarkana, TX 75503-0921

Mailing address

4140 McKnight Rd
Texarkana, TX 75503-0921
Phone (903) 824-2624

National Provider Directory

National Provider Directory

Locations

4140 McKnight Rd
Texarkana, TX 75503
Phone (903) 224-3022

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1582502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583193600000",
    "number": "1093349581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4140 MCKNIGHT RD",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755030921",
            "telephone_number": "903-824-2624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4140 MCKNIGHT RD",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755030921",
            "telephone_number": "903-824-2624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXARKANA MENTAL HEALTH AND WELLNESS CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-24",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A",
        "authorized_official_last_name": "SELLERS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "LICENSED PROFESSION COUNSELOR",
        "authorized_official_telephone_number": "903-824-2624",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPC-S"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Texarkana, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2020; 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.