Active NPI
Athena Crockett, M.S., M.ED., LPC
- Professional Counselor
- Lewisville, TX
National Provider Identifier
1265785778
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 18163
- Practice address
- 131 Degan Ave
Suite 102
Lewisville, TX 75057-3622 - Phone
- (972) 571-0971
- NPI assigned
- Oct 22, 2012
- Last updated
- Oct 22, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 18163 | TX | Primary |
Addresses
Primary practice location
131 Degan Ave
Suite 102
Lewisville, TX 75057-3622
Mailing address
477 Richland St
Lewisville, TX 75057-3755
Phone (972) 571-0971
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)
- Not enrolled
- Credentials
- Master of Education, Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18163 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1350864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350864000000",
"number": "1265785778",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "477 RICHLAND ST",
"city": "LEWISVILLE",
"state": "TX",
"postal_code": "750573755",
"telephone_number": "972-571-0971"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "131 DEGAN AVE",
"address_2": "SUITE 102",
"city": "LEWISVILLE",
"state": "TX",
"postal_code": "750573622",
"telephone_number": "972-571-0971"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROCKETT",
"first_name": "ATHENA",
"credential": "M.S., M.ED., LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-10-22",
"last_updated": "2012-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "18163",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.