Individual provider Active NPI

Jessica Sprengle, MA, LPC

  • Mental Health Counselor
  • Austin, TX
National Provider Identifier
1487197836
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
79844 Issued in TX
Practice address
4131 Spicewood Springs Rd Ste H2
Austin, TX 78759-8659
Phone
(732) 707-5377
NPI assigned
Dec 1, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 37PC00600400 NJ
Mental Health Counselor 101YM0800X 79844 TX Primary

Addresses

Primary practice location

4131 Spicewood Springs Rd Ste H2
Austin, TX 78759-8659

Mailing address

4131 Spicewood Springs Rd Ste H2
Austin, TX 78759-8659

Other names 1

  • Jessica Melillo Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Feb 14, 2024 through Feb 14, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
37PC00600400NJMDMental Health Counselor
79844TXMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1480550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709164800000",
    "number": "1487197836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4131 SPICEWOOD SPRINGS RD STE H2",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787598659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4131 SPICEWOOD SPRINGS RD STE H2",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787598659",
            "telephone_number": "732-707-5377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPRENGLE",
        "first_name": "JESSICA",
        "credential": "MA, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-01",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "37PC00600400",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "79844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "MELILLO",
            "credential": "MA, LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.