NPIMap

Organization Active NPI

The Well House Group, PLLC

  • Mental Health Counselor
  • Southlake, TX
National Provider Identifier
1902296379
Registry record updated Jan 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
67477 Issued in TX
Legal business name
THE WELL HOUSE GROUP, PLLC
Practice address
2140 E Southlake Blvd
Suite L, 687
Southlake, TX 76092-6516
Phone
(817) 371-0863
NPI assigned
Jan 23, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2015

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

Authorized official

Name
Jennifer KruseNPI 1710394663
Title
Manager
Phone
(817) 371-0863

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 67477 TX Primary

Addresses

Primary practice location

2140 E Southlake Blvd
Suite L, 687
Southlake, TX 76092-6516

Mailing address

2140 E Southlake Blvd
Suite L, 687
Southlake, TX 76092-6516
Phone (817) 371-0863

National Provider Directory

National Provider Directory

Locations

2140 E Southlake Blvd
Ste L
Southlake, TX 76092
Phone (817) 371-0863

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1421971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421971200000",
    "number": "1902296379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2140 E SOUTHLAKE BLVD",
            "address_2": "SUITE L, 687",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926516",
            "telephone_number": "817-371-0863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2140 E SOUTHLAKE BLVD",
            "address_2": "SUITE L, 687",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926516",
            "telephone_number": "817-371-0863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE WELL HOUSE GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-23",
        "last_updated": "2015-01-23",
        "status": "A",
        "authorized_official_last_name": "KRUSE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "817-371-0863"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "67477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southlake, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2015; 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.