Jaquana Mendez, CASAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

1575 Washington St
Watertown, NY 13601-9371

Phone

(315) 779-5060

Fax

(315) 779-5028

NPI assigned

May 30, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1559174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559174400000",
    "number": "1003474511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1575 WASHINGTON ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136019371",
            "telephone_number": "315-779-5060",
            "fax_number": "315-779-5028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 WASHINGTON ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136019371",
            "telephone_number": "315-779-5060",
            "fax_number": "315-779-5028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDEZ",
        "first_name": "JAQUANA",
        "credential": "CASAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-30",
        "last_updated": "2019-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03001594",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmendez@shsny.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1575 Washington St",
            "city": "Watertown",
            "state": "NY",
            "country_code": "US",
            "postal_code": "136019371",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Caitrin McPherson
• Mark Joseph McWilliams, DDS
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• Kayode Medugbon, PHARMD
• Melinda Iketau
• Margaret Ruth Mendoza, PSY.D.
• Mercy Hospital of Watertown United States Catholic Conference
• Mercy of Northern New York
• Rebecca Mae Merwin
• Amy A Messina

• All providers in Watertown, NY
• Addiction (Substance Use Disorder) Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2019; 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.