Individual provider Active NPI

Joan Kerley, LPC

  • Counselor
  • Fort Worth, TX
National Provider Identifier
1750630893
Registry record updated Sep 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
65775 Issued in TX
Practice address
7833 Oakmont Blvd
Fort Worth, TX 76132-4231
Phone
(817) 944-0064
NPI assigned
Sep 5, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 65775 TX Primary

Addresses

Primary practice location

7833 Oakmont Blvd
Fort Worth, TX 76132-4231

Mailing address

7833 Oakmont Blvd
Fort Worth, TX 76132-4231
Phone (817) 944-0064

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

LicenseStateTypeSpecialty
65775TXMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Counselor Current Accepting new patients
JDK Counseling Services LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: joankerley@tdh.allscriptsdirect.net

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1346803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346803200000",
    "number": "1750630893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7833 OAKMONT BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761324231",
            "telephone_number": "817-944-0064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7833 OAKMONT BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761324231",
            "telephone_number": "817-944-0064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERLEY",
        "first_name": "JOAN",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-05",
        "last_updated": "2012-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TX",
            "license": "65775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 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.

Verify at the official NPI Registry.