Active NPI
Jaclyn Nicole Abell, LPC, NCC
- Mental Health Counselor
- Tyler, TX
National Provider Identifier
1962842237
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 68051
- Practice address
- 1101 E Southeast Loop 323 Ste 225
Tyler, TX 75701-1243 - Phone
- (430) 220-0177
- NPI assigned
- Jul 1, 2013
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 68051 | TX | Primary |
Addresses
Primary practice location
1101 E Southeast Loop 323 Ste 225
Tyler, TX 75701-1243
Mailing address
1101 Ese Loop323 Ste 225
Tyler, TX 75701-1243
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240502001905 | TX | Practitioner - Mental Health Counselor | 7012357429 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 68051 | TX | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grow Healthcare Group PA | Mental Health | Current | Accepting new patients |
| Tyler Counseling & Assessment Center | Professional | Past | Accepting new patients |
| Ron L. Roberts, M.S., P.C. | Professional | Past | Accepting new patients |
Locations
66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711
700 Milam St
Ste 1300
Houston, TX 77002
Phone (281) 801-8391
Organizations & group practices 3
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1372636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711324800000",
"number": "1962842237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1101 ESE LOOP323 STE 225",
"city": "TYLER",
"state": "TX",
"postal_code": "757011243"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 E SOUTHEAST LOOP 323 STE 225",
"city": "TYLER",
"state": "TX",
"postal_code": "757011243",
"telephone_number": "430-220-0177"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ABELL",
"first_name": "JACLYN",
"middle_name": "NICOLE",
"credential": "LPC, NCC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-07-01",
"last_updated": "2024-03-25",
"certification_date": "2024-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "68051",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tyler, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.