Active NPI
Jennifer Abraham, LPC, NCC
- Emotionally Disturbed Childrens' Residential Treatment Facility
- Denton, TX
National Provider Identifier
1699092320
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emotionally Disturbed Childrens' Residential Treatment Facility
- License
- 63246
- Practice address
- 4601 N I-35
Denton, TX 76207-3419 - Phone
- (940) 484-8232
- NPI assigned
- Apr 20, 2010
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emotionally Disturbed Childrens' Residential Treatment Facility | 322D00000X | 63246 | TX | Primary |
Addresses
Primary practice location
4601 N I-35
Denton, TX 76207-3419
Mailing address
4601 N I-35
Denton, TX 76207-3419
Phone (940) 484-8232
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 63246 | TX | MD | Emotionally Disturbed Childrens' Residential Treatment Facility |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lutheran Social Services of the South, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Emotionally Disturbed Childrens' Residential Treatment Facility
- Denton, TX
- NPI 1528193018
Residential Treatment Facility, Emotionally Disturbed Children
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1271721600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1271721600000",
"number": "1699092320",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4601 N I-35",
"city": "DENTON",
"state": "TX",
"postal_code": "762073419",
"telephone_number": "940-484-8232"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4601 N I-35",
"city": "DENTON",
"state": "TX",
"postal_code": "762073419",
"telephone_number": "940-484-8232"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ABRAHAM",
"first_name": "JENNIFER",
"credential": "LPC, NCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-04-20",
"last_updated": "2010-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "322D00000X",
"taxonomy_group": "",
"desc": "Residential Treatment Facility, Emotionally Disturbed Children",
"state": "TX",
"license": "63246",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Denton, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.