Jenisse Marie Matias

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

7824 Issued in PR

Practice address

Calle Dr Basora 55-N
Edificio Medico IV 201
Mayaguez, PR 00682

Phone

(787) 265-5583

NPI assigned

Feb 2, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Opciones Psicoeducativas Inc

  • Clinic/Center
  • Mayaguez, PR
  • NPI 1679233597
  NPD
• Opciones Psicoeducativas

  • Psychologist
  • Mayaguez, PR
  • NPI 1902964760
  NPD (past)

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

{
    "created_epoch": "1706832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706832000000",
    "number": "1013770908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ALTURAS DE MAYAGUEZ",
            "address_2": "1900 CALLE LALIZA",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "00682",
            "telephone_number": "787-909-7534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE DR BASORA 55-N",
            "address_2": "EDIFICIO MEDICO IV 201",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "00682",
            "telephone_number": "787-265-5583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATIAS",
        "first_name": "JENISSE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-02",
        "last_updated": "2024-02-02",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "PR",
            "license": "7824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Priscilla Joanne Marty Irizarry, MSW
• Jaime Massa
• Laura Mata Balderas, M.D.
• Indrid Janette Matias Padilla
• Felix Matias, AUDIOLOGIST
• Marilu Matias
• Jonathan Matos Ferreira Sr., MSW
• Dixon E Matos Montalvo
• Leslie Ann Matos Torres
• Abigail Matos-Pagan, ANPC, DNP

• Counseling Psychologist in Mayaguez, PR
• Providers in Mayaguez, PR by specialty
• Counseling Psychologist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2024; 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.