Individual provider Active NPI

Jon Sebastian Klein, MA, LPC-S, LSOTP

  • Mental Health Counselor
  • Amarillo, TX
National Provider Identifier
1871611491
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
19598 Issued in TX
Practice address
3611 S. Soncy
Suite 7B
Amarillo, TX 79119
Phone
(806) 305-1717
Fax
(806) 340-0774
NPI assigned
Mar 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

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 19598 TX Primary

Addresses

Primary practice location

3611 S. Soncy
Suite 7B
Amarillo, TX 79119

Mailing address

3611 S. Soncy
Suite 7B
Amarillo, TX 79119
Phone (806) 305-1717

Other identifiers 2

IdentifierTypeStateIssuer
751551522OtherTXTAX ID#
174634901MedicaidTX

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
19598TXMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1871611491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3611 S. SONCY",
            "address_2": "SUITE 7B",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "79119",
            "telephone_number": "806-305-1717",
            "fax_number": "806-340-0774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3611 S. SONCY",
            "address_2": "SUITE 7B",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "79119",
            "telephone_number": "806-305-1717",
            "fax_number": "806-340-0774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEIN",
        "first_name": "JON",
        "middle_name": "SEBASTIAN",
        "name_prefix": "Mr.",
        "credential": "MA, LPC-S, LSOTP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "19598",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID#",
            "identifier": "751551522",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "174634901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 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.