Individual provider Active NPI

Jodie Bergquist, DPC, LPC-S, LCDC

  • Professional Counselor
  • Katy, TX
National Provider Identifier
1144679697
Registry record updated Jul 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
71819 Issued in TX
Practice address
26717 Westheimer Pkwy Ste 1002
Katy, TX 77494-8136
Phone
(832) 781-2153
Fax
(855) 707-6097
NPI assigned
Jun 6, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 12785 TX
Professional Counselor 101YP2500X 71819 TX Primary
Professional Counselor 101YP2500X 5351 TN

Addresses

Primary practice location

26717 Westheimer Pkwy Ste 1002
Katy, TX 77494-8136

Mailing address

26717 Westheimer Pkwy Ste 1002
Katy, TX 77494-8136
Phone (832) 781-2153

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
71819TXMDProfessional Counselor
12785TXMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Redefine Life Holistic Psychotherapy, LLC CurrentSince Jul 23, 2023 Accepting new patients

Locations

26717 Westheimer Pkwy
Ste 1002
Katy, TX 77494

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1465171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785369600000",
    "number": "1144679697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26717 WESTHEIMER PKWY STE 1002",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774948136",
            "telephone_number": "832-781-2153",
            "fax_number": "855-707-6097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26717 WESTHEIMER PKWY STE 1002",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774948136",
            "telephone_number": "832-781-2153",
            "fax_number": "855-707-6097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGQUIST",
        "first_name": "JODIE",
        "name_prefix": "Dr.",
        "credential": "DPC, LPC-S, LCDC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-06",
        "last_updated": "2026-07-30",
        "certification_date": "2026-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "12785",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "71819",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TN",
            "license": "5351",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2026; 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.