Individual provider Active NPI

Jacqueline Nwevo, M.ED

  • Mental Health Counselor
  • Beaumont, TX
National Provider Identifier
1477323558
Registry record updated Jan 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
84002 Issued in TX
Practice address
3685 Saint Andrews Dr
Beaumont, TX 77707-5480
Phone
(409) 812-6125
NPI assigned
Jan 8, 2024
Last updated
Jan 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2024

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 84002 TX Primary

Addresses

Primary practice location

3685 Saint Andrews Dr
Beaumont, TX 77707-5480

Mailing address

3685 Saint Andrews Dr
Beaumont, TX 77707-5480
Phone (409) 812-6125

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
I20260112001995 TX Practitioner - Mental Health Counselor 7416433206 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

825 Watters Creek Blvd
Suite 250
Allen, TX 75013-3770

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
84002TXMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Global Remnant Behavior Health Services, PLLC Mental Health CurrentSince Jan 14, 2024 Accepting new patients
Faithful Therapy TX Corporation CurrentSince Jan 1, 2026 Accepting new patients

Locations

825 Watters Creek Blvd
Ste 250
Allen, TX 75013
Phone (833) 231-4673

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1704672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704672000000",
    "number": "1477323558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3685 SAINT ANDREWS DR",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777075480",
            "telephone_number": "409-812-6125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3685 SAINT ANDREWS DR",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777075480",
            "telephone_number": "409-812-6125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWEVO",
        "first_name": "JACQUELINE",
        "credential": "M.ED",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-08",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "84002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

Verify at the official NPI Registry.