Individual provider Active NPI

Jett Cutter Roberts, M.A., LPC

  • Professional Counselor
  • Dallas, TX
National Provider Identifier
1366848889
Registry record updated Nov 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
70446 Issued in TX
Practice address
12800 Preston Rd Ste 101
Dallas, TX 75230-1366
Phone
(972) 789-9600
NPI assigned
Nov 11, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2014

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 70446 TX Primary

Addresses

Primary practice location

12800 Preston Rd Ste 101
Dallas, TX 75230-1366

Mailing address

9600 Golf Lakes TRL Apt 1010
Dallas, TX 75231-5012
Phone (325) 721-9633

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
70446TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Realistic Expectations, PLLC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1415664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415664000000",
    "number": "1366848889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9600 GOLF LAKES TRL APT 1010",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752315012",
            "telephone_number": "325-721-9633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12800 PRESTON RD STE 101",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752301366",
            "telephone_number": "972-789-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "JETT",
        "middle_name": "CUTTER",
        "name_prefix": "Mr.",
        "credential": "M.A., LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-11",
        "last_updated": "2014-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "70446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.