Individual provider Active NPI

Jeffrey Kyle Fletcher, M.A.

  • Mental Health Counselor
  • Richardson, TX
National Provider Identifier
1780865840
Registry record updated Aug 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
62288 Issued in TX
Practice address
275 W Campbell Rd
Suite 121
Richardson, TX 75080-3601
Phone
(972) 322-5050
Fax
(972) 671-3102
NPI assigned
Nov 16, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2008

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 62288 TX Primary

Addresses

Primary practice location

275 W Campbell Rd
Suite 121
Richardson, TX 75080-3601

Mailing address

275 W Campbell Rd
Suite 121
Richardson, TX 75080-3601
Phone (972) 322-5050

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
62288TXMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1195171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218499200000",
    "number": "1780865840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 W CAMPBELL RD",
            "address_2": "SUITE 121",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750803601",
            "telephone_number": "972-322-5050",
            "fax_number": "972-671-3102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 W CAMPBELL RD",
            "address_2": "SUITE 121",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750803601",
            "telephone_number": "972-322-5050",
            "fax_number": "972-671-3102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLETCHER",
        "first_name": "JEFFREY",
        "middle_name": "KYLE",
        "name_prefix": "Mr.",
        "credential": "M.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-16",
        "last_updated": "2008-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "62288",
            "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 Aug 12, 2008; 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.