Jennifer Loeravasquez
NPI 1104254853ActiveIndividual· Counselor, Professional· Fort Worth, TX
Counselor, Professional with Blank Slate Therapy, practicing in Fort Worth, Texas. Enrolled in Medicare as practitioner - mental health counselor.
Overview
| NPI | 1104254853 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Oct 16, 2013 |
| Last updated in NPPES | Feb 20, 2014 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Counselor, Professional Primary | 101YP2500X | 67901 | TX |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Mental Health Counselor (TX) |
|---|
Education and affiliations
| Graduation year | 2010 |
|---|---|
| Medicare specialty | Mental Health Counselor |
Medical group
- Blank Slate TherapyFrisco, TX · 19 clinicians
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