Equilla Weatherton, M.S. NCC LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

70847 Issued in TX

Practice address

109 N Meadow St
Converse, TX 78109-2515

Phone

(726) 610-4404

Fax

(726) 204-8540

NPI assigned

Apr 13, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Equilla Gilmore Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1428883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633564800000",
    "number": "1659767960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 N MEADOW ST",
            "city": "CONVERSE",
            "state": "TX",
            "postal_code": "781092515",
            "telephone_number": "726-610-4404",
            "fax_number": "726-204-8540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 N MEADOW ST",
            "city": "CONVERSE",
            "state": "TX",
            "postal_code": "781092515",
            "telephone_number": "726-610-4404",
            "fax_number": "726-204-8540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEATHERTON",
        "first_name": "EQUILLA",
        "credential": "M.S. NCC LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-13",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TX",
            "license": "70847",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "70847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EQUILLA",
            "last_name": "GILMORE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Professional Counselor in Converse, TX
• Providers in Converse, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2021; 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.