NPIMap

Organization Active NPI

Anderson Cherokee Community Enrichment Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Jacksonville, TX
National Provider Identifier
1710015201
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
ANDERSON CHEROKEE COMMUNITY ENRICHMENT SERVICES
Practice address
1011 College Ave
Jacksonville, TX 75766
Phone
(903) 589-9000
NPI assigned
Feb 28, 2007
Last updated
Jun 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Authorized official

Name
Dianna Strom
Title
Reimbursement Coordinator
Phone
(903) 589-9000

Specialties & licenses 14

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X 17029 TX
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 63332 TX
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X
Community Health Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WC1500X 674004 TX
Community Health Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WC1500X 618031 TX
Licensed Vocational NurseGroup: 193200000X MULTI-SPECIALTY GROUP 164X00000X 051913 TX
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X H5197 TX
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X K2150 TX
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

1011 College Ave
Jacksonville, TX 75766

Mailing address

1011 College Ave
Jacksonville, TX 75766-3307
Phone (903) 589-9000

Other practice location 1

3320 S Loop 256
Palestine, TX 75801-6984
Phone (903) 721-6136

Other names 1

  • ACCESS Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080229000537 TX Part B Supplier - Clinic/Group Practice 4284718107 Receives reassigned benefits from 19 practitioners
1 other NPI on this enrollment
Practice locations: Palestine, TX; Jacksonville, TX

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

1011 College Ave
Jacksonville, TX 75766
Phone (903) 541-2577

1011 College Ave
Ste Mhm
Jacksonville, TX 75766

1011 College Ave
Ste Mhr
Jacksonville, TX 75766

Practitioners & affiliated clinicians

Practitioners 28

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718150400000",
    "number": "1710015201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 COLLEGE AVE",
            "city": "JACKSONVILLE",
            "state": "TX",
            "postal_code": "757663307",
            "telephone_number": "903-589-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 COLLEGE AVE",
            "city": "JACKSONVILLE",
            "state": "TX",
            "postal_code": "75766",
            "telephone_number": "903-589-9000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3320 S Loop 256",
            "address_purpose": "LOCATION",
            "city": "Palestine",
            "state": "TX",
            "postal_code": "758016984",
            "country_code": "US",
            "telephone_number": "903-721-6136",
            "fax_number": "903-589-3443",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ANDERSON CHEROKEE COMMUNITY ENRICHMENT SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A",
        "authorized_official_last_name": "STROM",
        "authorized_official_first_name": "DIANNA",
        "authorized_official_title_or_position": "REIMBURSEMENT COORDINATOR",
        "authorized_official_telephone_number": "903-589-9000"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": "TX",
            "license": "17029",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "63332",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WC1500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Community Health",
            "state": "TX",
            "license": "674004",
            "primary": false
        },
        {
            "code": "163WC1500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Community Health",
            "state": "TX",
            "license": "618031",
            "primary": false
        },
        {
            "code": "164X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Licensed Vocational Nurse",
            "state": "TX",
            "license": "051913",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "H5197",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "K2150",
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ACCESS",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "ACCESS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jacksonville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.