Jennifer Cummings Shotwell, LCDC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

14218 Issued in TX

Practice address

2626 Cole Ave Ste 300
Dallas, TX 75204-1094

Phone

(713) 557-8430

NPI assigned

Feb 12, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• PPW

  • Other Specialist/Technologist
  • Dallas, TX
  • NPI 1831806868
  NPD Authorized official
• Prime Counseling

  • Counselor
  • Dallas, TX
  • NPI 1588284848

  Addiction (Substance Use Disorder)

  NPD Authorized official
• Prime Counseling Inc.

  • Mental Health Counselor
  • Dallas, TX
  • NPI 1376373902

  Addiction (Substance Use Disorder)

  NPD Authorized official

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

{
    "created_epoch": "1518393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572480000000",
    "number": "1720587173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6472 TRAMMEL DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752142219",
            "telephone_number": "713-557-8430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2626 COLE AVE STE 300",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752041094",
            "telephone_number": "713-557-8430"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12810 Hillcrest Rd # B223",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752301525",
            "country_code": "US",
            "telephone_number": "713-557-8430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHOTWELL",
        "first_name": "JENNIFER",
        "middle_name": "CUMMINGS",
        "credential": "LCDC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-12",
        "last_updated": "2019-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "14218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaitlin Short, MS, LPC, NCC
• Katrina Margaret Short, PT
• Rebecca Ann Short, M.D.
• Michael Daniel Shortt, PA-C
• Nancy Soll Shosid, M.D.
• Kelsi Alexis Shough, OTR/L
• Sonia Shoukat, M.D
• Thomas Hugh Shoultz, M.D.
• Angela Gail Shoup, PH.D.
• Kelly K Shoup

• Addiction (Substance Use Disorder) Counselor in Dallas, TX
• Providers in Dallas, TX by specialty
• Addiction (Substance Use Disorder) Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2019; 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.

Verify at the official NPI Registry.