Individual provider Active NPI

Jessica Pustka, LPC-S

  • Counselor
  • Harker Heights, TX
National Provider Identifier
1225415706
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
67424 Issued in TX
Practice address
2025 Memory LN Ste 500
Harker Heights, TX 76548-7489
Phone
(512) 826-9042
NPI assigned
May 4, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior TechnicianGroup: 193200000X MULTI-SPECIALTY GROUP 106S00000X
Counselor 101Y00000X 67424 TX Primary

Addresses

Primary practice location

2025 Memory LN Ste 500
Harker Heights, TX 76548-7489

Mailing address

132 Hematite LN
Jarrell, TX 76537-1844
Phone (512) 826-9042

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
67424TXMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1430697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1225415706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 HEMATITE LN",
            "city": "JARRELL",
            "state": "TX",
            "postal_code": "765371844",
            "telephone_number": "512-826-9042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 MEMORY LN STE 500",
            "city": "HARKER HEIGHTS",
            "state": "TX",
            "postal_code": "765487489",
            "telephone_number": "512-826-9042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUSTKA",
        "first_name": "JESSICA",
        "credential": "LPC-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-04",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TX",
            "license": "67424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harker Heights, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2023; 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.