Jaclyn Callahan, MA, LMHC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LH60603740 Issued in WA

Practice address

13401 NE Bel Red Rd
Bellevue, WA 98005-2322

Phone

(206) 350-7506

NPI assigned

Mar 6, 2008

Last updated

Sep 6, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Jaclyn Pentecost Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 31, 2024 through Jan 31, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Stone Creek Psychotherapy and Wellness Center

  • Mental Health Counselor
  • Katy, TX
  • NPI 1003009978
  NPD (past)

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

{
    "created_epoch": "1204761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1194995027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13401 NE BEL RED RD STE B12",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980052322",
            "telephone_number": "206-350-7506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13401 NE BEL RED RD",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980052322",
            "telephone_number": "206-350-7506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLAHAN",
        "first_name": "JACLYN",
        "credential": "MA, LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-06",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "63826",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WA",
            "license": "LH60603740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACLYN",
            "last_name": "PENTECOST",
            "credential": "LPC-I",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Russell B Caldwell, MD
• Rebecca Calhoun-Shepard
• Deborah Ann Calhoun, M.D.
• Amy M Calimlim, D.O.
• Anna Mae Callahan
• Samantha Callahan
• Erin Callihan, SP
• Marylee Calmes, M.S., L.AC., CCHM
• Jelena Calugay
• Randall Rex Calvert, DDS MS

• Professional Counselor in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Professional Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.