Individual provider Active NPI

Jennifer Washburn, LPC, LMFT

  • Professional Counselor
  • Grapevine, TX
National Provider Identifier
1164984266
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
70267 Issued in TX
Practice address
603 S Main St Ste 209
Grapevine, TX 76051-5387
Phone
(817) 714-1387
NPI assigned
Apr 5, 2019
Last updated
Aug 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 201958 TX
Professional Counselor 101YP2500X 70267 TX Primary

Addresses

Primary practice location

603 S Main St Ste 209
Grapevine, TX 76051-5387

Mailing address

4401 Little Rd Ste 550-103
Arlington, TX 76016-5624
Phone (817) 714-1387

Other practice location 1

4401 Little Rd Ste 550-103
Arlington, TX 76016-5624
Phone (817) 714-1387

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

LicenseStateTypeSpecialty
70267TXMDProfessional Counselor
201958TXMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1554422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1164984266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 LITTLE RD STE 550-103",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760165624",
            "telephone_number": "817-714-1387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 S MAIN ST STE 209",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760515387",
            "telephone_number": "817-714-1387"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4401 Little Rd Ste 550-103",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "TX",
            "postal_code": "760165624",
            "country_code": "US",
            "telephone_number": "817-714-1387",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WASHBURN",
        "first_name": "JENNIFER",
        "name_prefix": "Ms.",
        "credential": "LPC, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-05",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "201958",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "70267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grapevine, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.

Verify at the official NPI Registry.