Jason D Carlettini, MA, LPC, NCC
Individual provider Active NPI Professional Counselor · Bulverde, TX
NPI 1891368015 · NPPES record last updated Jan 15, 2024
Key facts
- NPI
- 1891368015
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 84124 (TX)
- Practice address
- 2631 Bulverde Rd Ste 108
Bulverde, TX 78163-2107 - Phone
- (830) 554-9687
- NPI assigned
- Jul 24, 2021
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240228002645 | TX | Practitioner - Mental Health Counselor | 2264877331 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 84124 | TX | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dasc LLC | Addiction (Substance Use Disorder) | Current |
Accepting new patients |
Locations
2631 Bulverde Rd
Ste 108
Bulverde, TX 78163
Phone (830) 554-9687
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 84124 | TX | |
| Mental Health Counselor | 101YM0800X | 84124 | TX | |
| Professional Counselor | 101YP2500X | 84124 | TX | Yes |
Addresses
Primary practice location
2631 Bulverde Rd Ste 108
Bulverde, TX 78163-2107
Mailing address
2631 Bulverde Rd Ste 108
Bulverde, TX 78163-2107
Phone (830) 590-1654
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | https://familymatterstx.theranest.com | Direct |
Other providers in Bulverde, TX
- Bulverde Point Dental, PLLC
- Bulverde Vision Center, PC
- Celeste Burt
- Mariza Lea Cardenas
- Breeann Carleton
- Jessica Carroll
- Lindsey Castilleja
- Elisa Ann Charles
- Brian Christopher Clark
- Alyssa Reigh Cobb
All providers in Bulverde, TX · Professional Counselor in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 15, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.