Jonathan Blake Vardell, L.P.C

Primary specialty

CounselorTaxonomy code 101Y00000X

License

74175 Issued in TX

Practice address

425 University Blvd
Round Rock, TX 78665-1047

Phone

(254) 724-2111

NPI assigned

May 29, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Blake Vardell Professional name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1369785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1841637923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752843855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 UNIVERSITY BLVD",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786651047",
            "telephone_number": "254-724-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARDELL",
        "first_name": "JONATHAN",
        "middle_name": "BLAKE",
        "name_prefix": "Mr.",
        "credential": "L.P.C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-29",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TX",
            "license": "74175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jvardell809730@direct.sw.org",
            "affiliation": "N",
            "address_1": "425 University Blvd",
            "city": "Round Rock",
            "state": "TX",
            "country_code": "US",
            "postal_code": "786651047",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "BLAKE",
            "last_name": "VARDELL",
            "credential": "LPC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jennifer Ann Van Wunnik, RN, BSN, CNOR, RNFA
• David Vander Straten, MD
• Ryan Paul Vaneaton, D.C.
• Patricia Hastings Vanwinkle, APRN, PMHNP-BC
• Criselda Vara, COTA
• Fabiola Vargas-Londono, BCBA
• Jasmine Leticia Vargas, RBT
• Marilu Vargas, LPC-A
• Marissa Aryn Vargas, DPT
• Lincy Varghese, DO

• Counselor in Round Rock, TX
• Providers in Round Rock, TX by specialty
• Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; 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.