Jacqueline Mary Williston, LPC, LCDC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

85356 Issued in TX

Practice address

173 W Main St Ste 6
Azle, TX 76020-3117

Phone

(817) 381-2290

Fax

(888) 909-5191

NPI assigned

Sep 5, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• We Persist Together Counseling, PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Azle, TX
  • NPI 1851234215
  NPD Authorized official

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

{
    "created_epoch": "1662336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662336000000",
    "number": "1780305102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 CLINIC DR STE A110",
            "city": "EULESS",
            "state": "TX",
            "postal_code": "760397453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "173 W MAIN ST STE 6",
            "city": "AZLE",
            "state": "TX",
            "postal_code": "760203117",
            "telephone_number": "817-381-2290",
            "fax_number": "888-909-5191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLISTON",
        "first_name": "JACQUELINE",
        "middle_name": "MARY",
        "credential": "LPC, LCDC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-05",
        "last_updated": "2022-09-05",
        "certification_date": "2022-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "15454",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "85356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.rockandrosewellness.com",
            "affiliation": "N",
            "endpointDescription": "Company website",
            "address_1": "173 W Main St Ste 6",
            "city": "Azle",
            "state": "TX",
            "country_code": "US",
            "postal_code": "760203117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• We Persist Together Counseling, PLLC
• Heather Wesolowski
• Heather R Wessner, PHARM. D.
• Sundye Marie West, FNP-C
• Misa J Wilcox, FNP-BC
• Doris Wreay, PHARMD
• Hans A Zambrano, MD

• Professional Counselor in Azle, TX
• Providers in Azle, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2022; 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.