Divine Path Ranch

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

DIVINE PATH RANCH

Doing business as

Divine Path Ranch

Practice address

6373 County Road 2520
Royse City, TX 75189-8017

Phone

(323) 639-8463

NPI assigned

Jun 20, 2023

Last updated

Jul 6, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Courtney Jaeckle, LPCNPI 1134736234

Title

Founder

Phone

(214) 415-5123

Specialties & licenses 1

Addresses

Other names 1

• Divine Path Ranch Doing business as

Practitioners 2

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.

• Courtney D Jaeckle, MA, LPC

  • Mental Health Counselor
  • Royse City, TX
  • NPI 1134736234
  NPD Authorized official
• Roger Earl Dawson

  • Student in an Organized Health Care Education/Training Program
  • Royse City, TX
  • NPI 1659297240
  NPD (past)

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

{
    "created_epoch": "1687219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688601600000",
    "number": "1265117030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 155",
            "city": "ROYSE CITY",
            "state": "TX",
            "postal_code": "751890155",
            "telephone_number": "214-415-5123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6373 COUNTY ROAD 2520",
            "city": "ROYSE CITY",
            "state": "TX",
            "postal_code": "751898017",
            "telephone_number": "323-639-8463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE PATH RANCH",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-20",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A",
        "authorized_official_last_name": "JAECKLE",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "214-415-5123",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Divine Path Ranch",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Laressa Elaine Dent
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• Cerena Derrick
• Kelsey Dosser, OT
• Gloria F Dukes, LMFT
• Sarah Pierce Dumas, LPC
• Aimee Theresa Dunnam, DNP, APRN, PMHNP-BC,
• East Texas Laboratory

• Mental Health Counselor in Royse City, TX
• Providers in Royse City, TX by specialty
• Mental Health Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 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.