Active NPI
Kalyn Jackson
- Counselor
- Katy, TX
National Provider Identifier
1346057494
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 92095
- Practice address
- 21002 Wildbrook Canyon CT
Katy, TX 77449-1764 - Phone
- (832) 403-5417
- NPI assigned
- Dec 12, 2024
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 92095 | TX | Primary |
Addresses
Primary practice location
21002 Wildbrook Canyon CT
Katy, TX 77449-1764
Mailing address
15840 FM 529 Rd Ste 310
Houston, TX 77095-2569
Other practice location 1
15840 Fm 529 Rd Ste 310
Houston, TX 77095-2569
Phone (281) 601-4284
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 92095 | TX | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1733961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733961600000",
"number": "1346057494",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15840 FM 529 RD STE 310",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770952569"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21002 WILDBROOK CANYON CT",
"city": "KATY",
"state": "TX",
"postal_code": "774491764",
"telephone_number": "832-403-5417"
}
],
"practiceLocations": [
{
"address_1": "15840 Fm 529 Rd Ste 310",
"address_purpose": "LOCATION",
"city": "Houston",
"state": "TX",
"postal_code": "770952569",
"country_code": "US",
"telephone_number": "281-601-4284",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JACKSON",
"first_name": "KALYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-12-12",
"last_updated": "2024-12-12",
"certification_date": "2024-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "TX",
"license": "92095",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Katy, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.