Jackeline Guillon, EDD, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

55941 Issued in TX

Practice address

2326 E 25TH St
Mission, TX 78574-7622

Phone

(956) 648-8720

NPI assigned

Jun 30, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Activate CR, PLLCGroup PAC ID 5193255099, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Activate CR, PLLC

  • Nephrology Physician
  • Frisco, TX
  • NPI 1063221851
  Medicare reassignment Care Compare group NPD
• Mental Health Specialty Group PA

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  TX

  Medicare reassignment NPD

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

{
    "created_epoch": "1625011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1881264034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2326 E 25TH ST",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785747622",
            "telephone_number": "956-648-8720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2326 E 25TH ST",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785747622",
            "telephone_number": "956-648-8720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUILLON",
        "first_name": "JACKELINE",
        "name_prefix": "Dr.",
        "credential": "EDD, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-30",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "55941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jesus Othon Guerra III, D.D.S.
• Jose Arturo Guerra Jr., M.S. CCC-SLP
• Maria Guerrero
• Olga Guerrero
• Lizett M. Guevara, OTR
• Swati Gupta, PT
• Ana B Gutierrez, REGISTERED NURSE
• Vanessa Gutierrez
• Yadhira Gutierrez
• Guzman Pediatric Dentistry

• Clinical Social Worker in Mission, TX
• Providers in Mission, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.