Individual provider Active NPI

Precious Rochelle Kennon

  • Mental Health Counselor
  • Austin, TX
National Provider Identifier
1417826850
Registry record updated Nov 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
95104
Practice address
12430 Metric Blvd Apt 3101
Austin, TX 78758-5498
Phone
(708) 378-3304
NPI assigned
Nov 3, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 95104 Primary

Addresses

Primary practice location

12430 Metric Blvd Apt 3101
Austin, TX 78758-5498

Mailing address

12430 Metric Blvd Apt 3101
Austin, TX 78758-5498
Phone (708) 378-3304

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.

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

12430 Metric Blvd
Apt 3101
Austin, TX 78758-5398

535 Mack Ave
Kingsley, MI 49649-9220

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1762128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762128000000",
    "number": "1417826850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12430 METRIC BLVD APT 3101",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787585498",
            "telephone_number": "708-378-3304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12430 METRIC BLVD APT 3101",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787585498",
            "telephone_number": "708-378-3304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNON",
        "first_name": "PRECIOUS",
        "middle_name": "ROCHELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-11-03",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": "95104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.