Active NPI
Jodie Lynette Elder
- Professional Counselor
- Dallas, TX
National Provider Identifier
1598330037
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 61492
- Practice address
- 7031 Mason Dells Dr
Dallas, TX 75230-3151 - Phone
- (361) 319-4608
- NPI assigned
- May 26, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 201089 | TX | |
| Professional Counselor | 101YP2500X | 61492 | TX | Primary |
Addresses
Primary practice location
7031 Mason Dells Dr
Dallas, TX 75230-3151
Mailing address
PO Box 670083
Dallas, TX 75367-0083
Phone (469) 573-4035
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Mar 11, 2024 through Mar 11, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61492 | TX | MD | Professional Counselor |
| 201089 | TX | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621987200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621987200000",
"number": "1598330037",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 670083",
"city": "DALLAS",
"state": "TX",
"postal_code": "753670083",
"telephone_number": "469-573-4035"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7031 MASON DELLS DR",
"city": "DALLAS",
"state": "TX",
"postal_code": "752303151",
"telephone_number": "361-319-4608"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELDER",
"first_name": "JODIE",
"middle_name": "LYNETTE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-05-26",
"last_updated": "2021-05-26",
"certification_date": "2021-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "TX",
"license": "201089",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "61492",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.