NPIMap

Organization Active NPI

Premier Neurofeedback & Counseling Services, PLLC

Doing business as Premier Neurofeedback and Counseling Services, PLLC

  • Mental Health Counselor
  • Waco, TX
National Provider Identifier
1235620568
Registry record updated Mar 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
63523 Issued in TX
Legal business name
PREMIER NEUROFEEDBACK & COUNSELING SERVICES, PLLC
Doing business as
Premier Neurofeedback & Counseling Services, PLLC
Premier Neurofeedback and Counseling Services, PLLC
Practice address
510 N Valley Mills Dr Ste 304
Waco, TX 76710-6076
Phone
(254) 262-3506
Fax
(254) 298-9432
NPI assigned
May 22, 2018
Last updated
Mar 16, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2026

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

Authorized official

Name
Kristy M DonaldsonNPI 1871867176
Title
Owner
Phone
(254) 262-3506

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 MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X 63523 TX Primary

Addresses

Primary practice location

510 N Valley Mills Dr Ste 304
Waco, TX 76710-6076

Mailing address

510 N Valley Mills Dr Ste 304
Waco, TX 76710-6076
Phone (254) 848-6284

Other identifiers 1

IdentifierTypeStateIssuer
391171101MedicaidTX

Other names 2

  • Premier Neurofeedback & Counseling Services, PLLC Doing business as
  • Premier Neurofeedback and Counseling Services, PLLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240124003192 TX Part B Supplier - Clinic/Group Practice 1658724810 Receives reassigned benefits from 7 practitioners
Practice locations: Waco, TX

National Provider Directory

National Provider Directory

Locations

510 N Valley Mills Dr
Ste 304
Waco, TX 76710
Phone (254) 262-3506

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1526947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773619200000",
    "number": "1235620568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 N VALLEY MILLS DR STE 304",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767106076",
            "telephone_number": "254-848-6284",
            "fax_number": "254-848-4193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 N VALLEY MILLS DR STE 304",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767106076",
            "telephone_number": "254-262-3506",
            "fax_number": "254-298-9432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER NEUROFEEDBACK & COUNSELING SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-22",
        "last_updated": "2026-03-16",
        "certification_date": "2026-03-16",
        "status": "A",
        "authorized_official_last_name": "DONALDSON",
        "authorized_official_first_name": "KRISTY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "254-262-3506"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "63523",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "391171101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Neurofeedback & Counseling Services, PLLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Premier Neurofeedback and Counseling Services, PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.