NPIMap

Organization Active NPI

Self Center PLLC

  • Mental Health Counselor
  • Richmond, TX
National Provider Identifier
1174235758
Registry record updated Dec 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
SELF CENTER PLLC
Practice address
1010 Williams Lake Dr
Richmond, TX 77469-4295
Phone
(601) 807-5030
NPI assigned
Dec 15, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2022

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

Authorized official

Name
Natalie Jackson, LPCNPI 1548746118
Title
Director
Phone
(601) 807-5030

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
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

1010 Williams Lake Dr
Richmond, TX 77469-4295

Mailing address

1010 Williams Lake Dr
Richmond, TX 77469-4295
Phone (601) 807-5030

National Provider Directory

National Provider Directory

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": "1671062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671062400000",
    "number": "1174235758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 WILLIAMS LAKE DR",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774694295",
            "telephone_number": "601-807-5030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 WILLIAMS LAKE DR",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774694295",
            "telephone_number": "601-807-5030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELF CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-15",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "NATALIE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "601-807-5030",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2022; 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.