Individual provider Active NPI

David Jaskowiak, LPC

  • Professional Counselor
  • Harker Heights, TX
National Provider Identifier
1477055507
Registry record updated Feb 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
74530 Issued in TX
Practice address
775 Indian TRL Ste 200
Harker Heights, TX 76548-7026
Phone
(877) 800-5722
NPI assigned
Mar 5, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2021

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
Professional Counselor 101YP2500X 74530 TX Primary

Addresses

Primary practice location

775 Indian TRL Ste 200
Harker Heights, TX 76548-7026

Mailing address

205 E University Ave Ste 200
Georgetown, TX 78626-6821
Phone (512) 686-0207

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address david.jaskowiak.p1@direct.lscctx.nextgenshare.com

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
I20240123003258 TX Practitioner - Mental Health Counselor 1951753177 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
74530TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Counties Center for Mental Health & Mental Retardation SRVS CurrentSince Jul 9, 2024 Accepting new patients
Central Counties Center for Mental Health & Mental Retardation SRVS Current Accepting new patients
Family Care Center LLC, CurrentSince Jan 1, 2024 Accepting new patients
Family Care Center, LLC Professional CurrentSince Jan 1, 2024 Accepting new patients

Locations

3705 Medical Pkwy
Ste 410
Austin, TX 78705
Phone (512) 320-5779

551 S Interstate 35
Ste 200
Round Rock, TX 78664
Phone (512) 241-7314

304 S 22nd St
Temple, TX 76501
Phone (254) 298-7000

Organizations & group practices 4

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": "1520208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614124800000",
    "number": "1477055507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 E UNIVERSITY AVE STE 200",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786266821",
            "telephone_number": "512-686-0207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 INDIAN TRL STE 200",
            "city": "HARKER HEIGHTS",
            "state": "TX",
            "postal_code": "765487026",
            "telephone_number": "877-800-5722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JASKOWIAK",
        "first_name": "DAVID",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-03-05",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "74530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "david.jaskowiak.p1@direct.lscctx.nextgenshare.com",
            "affiliation": "N",
            "address_1": "775 Indian Trl Ste 200",
            "city": "Harker Heights",
            "state": "TX",
            "country_code": "US",
            "postal_code": "765487026",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Harker Heights, TX

Sources for this page

Verify at the official NPI Registry.