Jerilyn Pope, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

19297 Issued in TX

Practice address

7006 Kildare CV
Austin, TX 78724-3654

Phone

(682) 465-2648

NPI assigned

Aug 6, 2020

Reactivated

Jun 23, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1596672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1114537883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 454",
            "city": "IDAHO CITY",
            "state": "ID",
            "postal_code": "836310454",
            "telephone_number": "682-465-2648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7006 KILDARE CV",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787243654",
            "telephone_number": "682-465-2648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POPE",
        "first_name": "JERILYN",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-06",
        "last_updated": "2023-08-22",
        "certification_date": "2023-06-28",
        "deactivation_date": "2021-02-25",
        "reactivation_date": "2023-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "19297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Conroe",
            "affiliation": "N",
            "address_1": "2415 Coachlight Ln",
            "city": "Conroe",
            "state": "TX",
            "country_code": "US",
            "postal_code": "773843348",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sarah Wilson Poole
• Shanna C. Poole, MS
• Stephanie Poonawala, APRN
• Samar Poorlakani, LPC
• Bonnie Leigh Pope, APRN
• Nathan Pope, PHARM.D.
• Paul Allen Pope
• Shelby Kristin Pope, CRNA
• Jared Poplin, DMD
• Melissa Marie Poppenhusen, OD

• Professional Counselor in Austin, TX
• Providers in Austin, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; 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.