Individual provider Active NPI

Jacqueline Klassen, LPC-A

  • Professional Counselor
  • Sherman, TX
National Provider Identifier
1295566354
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
9547 Issued in TX
Practice address
804 Pecan Grove Rd E
Sherman, TX 75090-1767
Phone
(903) 893-7768
NPI assigned
Aug 12, 2024
Last updated
Aug 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 9547 TX Primary

Addresses

Primary practice location

804 Pecan Grove Rd E
Sherman, TX 75090-1767

Mailing address

918 S Travis St
Sherman, TX 75090-7920
Phone (903) 421-6950

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
I20260519003085 TX Practitioner - Mental Health Counselor 4587133533 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Child and Family Guidance Center of TexomaGroup PAC ID 7911246657, 5 clinicians

Practice addresses (Care Compare)

804 Pecan Grove Rd E
Sherman, TX 75090-1767
Phone (903) 893-7768

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Child and Family Guidance Center of Texoma CurrentSince Aug 18, 2024 Accepting new patients

Locations

804 Pecan Grove Rd E
Sherman, TX 75090
Phone (903) 893-7768

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1723420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1295566354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "918 S TRAVIS ST",
            "city": "SHERMAN",
            "state": "TX",
            "postal_code": "750907920",
            "telephone_number": "903-421-6950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 PECAN GROVE RD E",
            "city": "SHERMAN",
            "state": "TX",
            "postal_code": "750901767",
            "telephone_number": "903-893-7768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLASSEN",
        "first_name": "JACQUELINE",
        "credential": "LPC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-12",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "9547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman, TX

Sources for this page

Verify at the official NPI Registry.