Individual provider Active NPI

Jenny Leann Burkholder, PH.D., LMFT, LPC

  • Marriage & Family Therapist
  • Cypress, TX
National Provider Identifier
1447592852
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
201540 Issued in TX
Practice address
14930 Mueschke Rd Ste 100
Cypress, TX 77433-0980
Phone
(346) 206-3992
Fax
(832) 652-3626
NPI assigned
Mar 24, 2013
Sex
Female
Sole proprietor
Yes

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 70895 TX
Marriage & Family Therapist 106H00000X 201540 TX Primary

Addresses

Primary practice location

14930 Mueschke Rd Ste 100
Cypress, TX 77433-0980

Mailing address

28652 Sharon Louise
Magnolia, TX 77355-4611
Phone (832) 540-0091

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
I20240409003795 TX Practitioner - Marriage and Family Therapist 7113212325 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
70895TXMDPharmacist

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": "1364083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1447592852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28652 SHARON LOUISE",
            "city": "MAGNOLIA",
            "state": "TX",
            "postal_code": "773554611",
            "telephone_number": "832-540-0091",
            "fax_number": "832-652-3626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14930 MUESCHKE RD STE 100",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774330980",
            "telephone_number": "346-206-3992",
            "fax_number": "832-652-3626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKHOLDER",
        "first_name": "JENNY",
        "middle_name": "LEANN",
        "name_prefix": "Dr.",
        "credential": "PH.D., LMFT, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-24",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "70895",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "201540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cypress, TX

Sources for this page

Verify at the official NPI Registry.