Individual provider Active NPI

Jessica L. Nolen, LPC-INTERN

  • Mental Health Counselor
  • Plano, TX
National Provider Identifier
1205465267
Registry record updated Apr 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
82975 Issued in TX
Practice address
5601 Democracy Dr Ste 135
Plano, TX 75024-3672
Phone
(940) 765-9029
NPI assigned
Apr 2, 2020
Last updated
Apr 2, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 82975 TX Primary

Addresses

Primary practice location

5601 Democracy Dr Ste 135
Plano, TX 75024-3672

Mailing address

1322 Navaho TRL
Richardson, TX 75080-3741
Phone (214) 707-6709

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240501003195 TX Practitioner - Mental Health Counselor 5991145427 Practice locations: Richardson, TX

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2011 N Collins Blvd
Suite 801
Richardson, TX 75080-2690
Phone (214) 755-0329

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1585785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585785600000",
    "number": "1205465267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1322 NAVAHO TRL",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750803741",
            "telephone_number": "214-707-6709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 DEMOCRACY DR STE 135",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750243672",
            "telephone_number": "940-765-9029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLEN",
        "first_name": "JESSICA",
        "middle_name": "L.",
        "credential": "LPC-INTERN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-02",
        "last_updated": "2020-04-02",
        "certification_date": "2020-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "82975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.