Active NPI
Annette M. Kerr, LPC
- Professional Counselor
- Mansfield, TX
National Provider Identifier
1760758379
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 74738
- Practice address
- 1807 Lakes Edge Blvd
Mansfield, TX 76063-4020 - Phone
- (682) 808-3769
- NPI assigned
- Mar 28, 2012
- Last updated
- May 2, 2016
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 0140551 | NM | |
| Professional Counselor | 101YP2500X | 0140551 | NM | |
| Professional Counselor | 101YP2500X | 74738 | TX | Primary |
Addresses
Primary practice location
1807 Lakes Edge Blvd
Mansfield, TX 76063-4020
Mailing address
5624 SW Green Oaks Blvd
Arlington, TX 76017-1161
Phone (682) 808-3769
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jun 13, 2024 through Jun 13, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0140551 | NM | MD | Mental Health Counselor |
| 74738 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1332892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1462147200000",
"number": "1760758379",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5624 SW GREEN OAKS BLVD",
"city": "ARLINGTON",
"state": "TX",
"postal_code": "760171161",
"telephone_number": "682-808-3769"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1807 LAKES EDGE BLVD",
"city": "MANSFIELD",
"state": "TX",
"postal_code": "760634020",
"telephone_number": "682-808-3769"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KERR",
"first_name": "ANNETTE",
"middle_name": "M.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-03-28",
"last_updated": "2016-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NM",
"license": "0140551",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NM",
"license": "0140551",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "74738",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mansfield, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2016; 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.