MRS. JILL RENEE VAN DYKE LPC-A
NPI 1962173005
Counselor - Mental Health in Prosper, TX
About Mrs. Jill Renee Van Dyke Lpc-a NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. JILL RENEE VAN DYKE LPC-A (NPI 1962173005) is an individual mental health provider in Prosper, Texas, licensed in Texas (84925) and active in the NPI registry since September 2021. She has opted out of Medicare through February 14, 2028.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Opted out of Medicare
Mrs. Jill Renee Van Dyke Lpc-a has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from February 14, 2024 through February 14, 2028.
Other Providers at the Same Location NPPES 16
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
PROSPER, TX 75078
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Jill Van Dyke's NPI number?
The NPI number for Jill Van Dyke is 1962173005. It was assigned to this individual provider in the NPPES registry on September 27, 2021.
Where is Jill Van Dyke located?
Jill Van Dyke practices at 161 W 3rd St Ste 100, Prosper, TX 75078. The listed phone number is (214) 618-8402.
What is Jill Van Dyke's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.
Is Jill Van Dyke enrolled in Medicare?
No. Jill Van Dyke has opted out of Medicare through February 14, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.
When was this NPI record last updated?
The NPPES record for Jill Van Dyke was last updated on September 27, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Mrs. Jill Renee Van Dyke, LPC-A · NPI 1962173005
Mental Health provider in Prosper, Texas. Individual provider, active in the CMS NPPES registry since September 27, 2021.
## Identity
- **NPI:** 1962173005 (Entity type: Individual)
- **Enumerated:** September 27, 2021
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **State license:** 84925 (Texas)
- **Sole proprietor:** No
## Practice location
- **Address:** 161 W 3RD ST STE 100, Prosper, TX 75078-2906
- **Phone:** (214) 618-8402
## Medicare
- **Medicare:** Opted out of Medicare (opt-out affidavit on file, in effect through February 14, 2028); services are provided under private contract
## Record status
- **NPPES last updated:** September 27, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1962173005) · Data from the CMS NPPES public registry.