Active NPI
Jennafer P Mountain, LPC, CST
- Professional Counselor
- Richardson, TX
National Provider Identifier
1780222745
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 69410
- Practice address
- 1701 N Collins Blvd Ste 235
Richardson, TX 75080-3553 - Phone
- (972) 294-3691
- NPI assigned
- Dec 20, 2019
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 69410 | TX | Primary |
Addresses
Primary practice location
1701 N Collins Blvd Ste 235
Richardson, TX 75080-3553
Mailing address
1701 N Collins Blvd Ste 235
Richardson, TX 75080-3553
Phone (972) 294-3691
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 1, 2024 through Feb 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 69410 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1576800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576800000000",
"number": "1780222745",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1701 N COLLINS BLVD STE 235",
"city": "RICHARDSON",
"state": "TX",
"postal_code": "750803553",
"telephone_number": "972-294-3691"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1701 N COLLINS BLVD STE 235",
"city": "RICHARDSON",
"state": "TX",
"postal_code": "750803553",
"telephone_number": "972-294-3691"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOUNTAIN",
"first_name": "JENNAFER",
"middle_name": "P",
"credential": "LPC, CST",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-12-20",
"last_updated": "2019-12-20",
"certification_date": "2019-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "69410",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richardson, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 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.