Active NPI
Jonathan Allen Mendez, LPC
- Professional Counselor
- Macon, GA
National Provider Identifier
1013489616
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC010577
- Practice address
- 2607 Vineville Ave Ste 107
Macon, GA 31204-0900 - Phone
- (478) 305-9913
- NPI assigned
- Dec 19, 2018
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC010577 | GA | Primary |
Addresses
Primary practice location
2607 Vineville Ave Ste 107
Macon, GA 31204-0900
Mailing address
2607 Vineville Ave Ste 107
Macon, GA 31204-0900
Phone (478) 305-9913
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC010577 | GA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1545177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1545177600000",
"number": "1013489616",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2607 VINEVILLE AVE STE 107",
"city": "MACON",
"state": "GA",
"postal_code": "312040900",
"telephone_number": "478-305-9913"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2607 VINEVILLE AVE STE 107",
"city": "MACON",
"state": "GA",
"postal_code": "312040900",
"telephone_number": "478-305-9913"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENDEZ",
"first_name": "JONATHAN",
"middle_name": "ALLEN",
"name_prefix": "Mr.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-12-19",
"last_updated": "2018-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "LPC010577",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Macon, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.