NPIMap

Organization Active NPI

Regenesis Counseling and Assessment Center

  • Clinical Social Worker
  • Cleburne, TX
National Provider Identifier
1477977205
Registry record updated Feb 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
28460 Issued in TX
Legal business name
REGENESIS COUNSELING AND ASSESSMENT CENTER
Practice address
906 W Henderson St
Cleburne, TX 76033-4836
Phone
(817) 264-6194
Fax
(866) 372-7985
NPI assigned
Feb 14, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2014

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

Authorized official

Name
Dr. Kenneth Jones, PSYD, LCSWNPI 1376762963
Title
Owner/Ceo
Phone
(817) 264-6194

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X 13478 TX
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 28460 TX Primary

Addresses

Primary practice location

906 W Henderson St
Cleburne, TX 76033-4836

Mailing address

906 W Henderson St
Cleburne, TX 76033-4836
Phone (817) 264-6194

Other identifiers 1

IdentifierTypeStateIssuer
280045001MedicaidTX

National Provider Directory

National Provider Directory
Tax ID family
Regenesis Counseling and Assessment Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1392336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392336000000",
    "number": "1477977205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "906 W HENDERSON ST",
            "city": "CLEBURNE",
            "state": "TX",
            "postal_code": "760334836",
            "telephone_number": "817-264-6194",
            "fax_number": "866-372-7985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 W HENDERSON ST",
            "city": "CLEBURNE",
            "state": "TX",
            "postal_code": "760334836",
            "telephone_number": "817-264-6194",
            "fax_number": "866-372-7985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENESIS COUNSELING AND ASSESSMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-14",
        "last_updated": "2014-02-14",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "817-264-6194",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD, LCSW"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "13478",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "28460",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "280045001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleburne, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.