Individual provider Active NPI

Danielle Fortune-Jack, LPC-A

  • Mental Health Counselor
  • Liberty Hill, TX
National Provider Identifier
1770442980
Registry record updated Jan 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
100007 Issued in TX
Practice address
221 Rangel Dr
Liberty Hill, TX 78642-2373
Phone
(512) 639-1300
NPI assigned
Jan 21, 2026
Last updated
Jan 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 100007 TX Primary

Addresses

Primary practice location

221 Rangel Dr
Liberty Hill, TX 78642-2373

Mailing address

221 Rangel Dr
Liberty Hill, TX 78642-2373
Phone (512) 639-1300

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
100007TXMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1768953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768953600000",
    "number": "1770442980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 RANGEL DR",
            "city": "LIBERTY HILL",
            "state": "TX",
            "postal_code": "786422373",
            "telephone_number": "512-639-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 RANGEL DR",
            "city": "LIBERTY HILL",
            "state": "TX",
            "postal_code": "786422373",
            "telephone_number": "512-639-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTUNE-JACK",
        "first_name": "DANIELLE",
        "credential": "LPC-A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-01-21",
        "last_updated": "2026-01-21",
        "certification_date": "2026-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "100007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty Hill, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2026; 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.