Active NPI
Jessica Chavolla, LPC
- Counselor
- Dallas, TX
National Provider Identifier
1871063255
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 75021
- Practice address
- 3720 Rawlins St Apt I
Dallas, TX 75219-4220 - Phone
- (240) 430-4897
- NPI assigned
- Nov 28, 2018
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 75021 | TX | Primary |
Addresses
Primary practice location
3720 Rawlins St Apt I
Dallas, TX 75219-4220
Mailing address
6418 Fisher Rd Apt 215a
Dallas, TX 75214-1695
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 75021 | TX | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1543363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1543363200000",
"number": "1871063255",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6418 FISHER RD APT 215A",
"city": "DALLAS",
"state": "TX",
"postal_code": "752141695"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3720 RAWLINS ST APT I",
"city": "DALLAS",
"state": "TX",
"postal_code": "752194220",
"telephone_number": "240-430-4897"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAVOLLA",
"first_name": "JESSICA",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-11-28",
"last_updated": "2018-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "TX",
"license": "75021",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.