Individual provider Active NPI

Jessica L. Vera, PH.D.

  • Mental Health Counselor
  • Boca Raton, FL
National Provider Identifier
1003919424
Registry record updated Nov 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH8093 Issued in FL
Practice address
9832 Grand Verde Way Apt 203
Boca Raton, FL 33428-3519
Phone
(954) 665-0319
NPI assigned
Sep 7, 2006
Last updated
Nov 28, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH8093 FL Primary

Addresses

Primary practice location

9832 Grand Verde Way Apt 203
Boca Raton, FL 33428-3519

Mailing address

9832 Grand Verde Way Apt 203
Boca Raton, FL 33428-3519
Phone (954) 665-0319

Other practice location 1

1451 W Cypress Creek Rd Ste 300
Ft Lauderdale, FL 33309-1953
Phone (954) 665-0319

Other identifiers 1

IdentifierTypeStateIssuer
766805800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240118004540 FL Practitioner - Mental Health Counselor 2961854542

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
MH8093FLMDMental Health Counselor

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701129600000",
    "number": "1003919424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9832 GRAND VERDE WAY APT 203",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334283519",
            "telephone_number": "954-665-0319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9832 GRAND VERDE WAY APT 203",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334283519",
            "telephone_number": "954-665-0319"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1451 W Cypress Creek Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Ft Lauderdale",
            "state": "FL",
            "postal_code": "333091953",
            "country_code": "US",
            "telephone_number": "954-665-0319",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VERA",
        "first_name": "JESSICA",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-07",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH8093",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "766805800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.