Active NPI
Jennifer Nicole Womack, LPC
- Professional Counselor
- Dallas, TX
National Provider Identifier
1770824013
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 68501
- Practice address
- 4104 N Hall St Apt 106
Dallas, TX 75219-5627 - Phone
- (214) 477-4333
- NPI assigned
- Mar 12, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 68501 | TX | |
| Professional Counselor | 101YP2500X | 68501 | TX | Primary |
Addresses
Primary practice location
4104 N Hall St Apt 106
Dallas, TX 75219-5627
Mailing address
4104 N Hall St
# 106
Dallas, TX 75219-3655
Phone (214) 477-4333
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
| License | State | Type | Specialty |
|---|---|---|---|
| 68501 | TX | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1363046400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1446249600000",
"number": "1770824013",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4104 N HALL ST",
"address_2": "# 106",
"city": "DALLAS",
"state": "TX",
"postal_code": "752193655",
"telephone_number": "214-477-4333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4104 N HALL ST APT 106",
"city": "DALLAS",
"state": "TX",
"postal_code": "752195627",
"telephone_number": "214-477-4333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOMACK",
"first_name": "JENNIFER",
"middle_name": "NICOLE",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-03-12",
"last_updated": "2015-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "TX",
"license": "68501",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "68501",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.