Individual provider Active NPI

Martin Keller Jeane, PH.D., LPC-S, LMFT

  • Professional Counselor
  • Mansfield, TX
National Provider Identifier
1790863355
Registry record updated Aug 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
08035 Issued in TX
Practice address
305 Regency Parkway
#601
Mansfield, TX 76063-7306
Phone
(817) 539-0499
Fax
(817) 539-0498
NPI assigned
Nov 1, 2006
Last updated
Aug 26, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 08035 TX Primary
Marriage & Family Therapist 106H00000X 116 TX

Addresses

Primary practice location

305 Regency Parkway
#601
Mansfield, TX 76063-7306

Mailing address

305 Regency Pkwy Ste 601
Mansfield, TX 76063-7306
Phone (817) 291-3635

Other identifiers 6

IdentifierTypeStateIssuer
10029868OtherTXAMERIGROUP PROV. ID
052194000OtherTXMAGELLAN PROV ID
143906OtherTXVALUEOPTIONS ID
1017LCOtherTXBLUE CROSS BLUE SHIELD
128615OtherTXMHN PROVIDER ID
025581201MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240116002009 TX Practitioner - Mental Health Counselor 8527410570 Practice locations: Mansfield, TX

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

305 Regency Pkwy
Suite 601
Mansfield, TX 76063-7306
Phone (817) 539-0499

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
08035TXMDProfessional Counselor
116TXMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Empowerment & Counseling Firm by Dr. Karen, PLLC PastSince Jan 1, 2024 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787702400000",
    "number": "1790863355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 REGENCY PKWY STE 601",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760637306",
            "telephone_number": "817-291-3635",
            "fax_number": "817-539-0498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 REGENCY PARKWAY",
            "address_2": "#601",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760637306",
            "telephone_number": "817-539-0499",
            "fax_number": "817-539-0498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEANE",
        "first_name": "MARTIN",
        "middle_name": "KELLER",
        "name_prefix": "Mr.",
        "credential": "PH.D., LPC-S, LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "08035",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "116",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP PROV. ID",
            "identifier": "10029868",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN PROV ID",
            "identifier": "052194000",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUEOPTIONS ID",
            "identifier": "143906",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1017LC",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN PROVIDER ID",
            "identifier": "128615",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "025581201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, TX

Sources for this page

Verify at the official NPI Registry.