Active NPI
Jody Lee Ebert, MS LPC
- Professional Counselor
- Carrollton, TX
National Provider Identifier
1689728255
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 68084
- Practice address
- 1100 W Jackson Rd
Carrollton, TX 75006-1316 - Phone
- (972) 242-2182
- NPI assigned
- Jan 22, 2007
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 6401007652 | MI | |
| Professional Counselor | 101YP2500X | 2007021398 | MO | |
| Professional Counselor | 101YP2500X | 68084 | TX | Primary |
Addresses
Primary practice location
1100 W Jackson Rd
Carrollton, TX 75006-1316
Mailing address
3103 Amber Forest TRL
Belton, TX 76513
Phone (254) 613-4158
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6401007652 | MI | MD | Professional Counselor |
| 2007021398 | MO | MD | Professional Counselor |
| 68084 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1339977600000",
"number": "1689728255",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3103 AMBER FOREST TRL",
"city": "BELTON",
"state": "TX",
"postal_code": "76513",
"telephone_number": "254-613-4158"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 W JACKSON RD",
"city": "CARROLLTON",
"state": "TX",
"postal_code": "750061316",
"telephone_number": "972-242-2182"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EBERT",
"first_name": "JODY",
"middle_name": "LEE",
"name_prefix": "Ms.",
"credential": "MS LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-22",
"last_updated": "2012-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MI",
"license": "6401007652",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MO",
"license": "2007021398",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "68084",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carrollton, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.