Kelcie Brynn Jimenez

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CMH0223011 Issued in NM

Practice address

7400 Hancock CT NE
Albuquerque, NM 87109-4591

Phone

(505) 600-6631

NPI assigned

Aug 21, 2018

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

Medicare fee-for-service enrollment

Enrolled in NM

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

Medicare enrollment (NPD)

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.

• Rise Above Therapy

  • Community/Behavioral Health Agency
  • Albuquerque, NM
  • NPI 1831904275
  Medicare reassignment NPD

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

{
    "created_epoch": "1534809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1043790868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8100 WYOMING BLVD NE M4-#240",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871131963",
            "telephone_number": "505-600-6631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7400 HANCOCK CT NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094591",
            "telephone_number": "505-600-6631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "KELCIE",
        "middle_name": "BRYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-21",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "CMH0223011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Jimenez Tennyson
• Mariana Jimenez-Gonzales
• Chandra Jimenez, RN
• David Ray Jimenez, D.D.S.
• Gretzel Yarie Jimenez
• Lisa A Jimenez, MD
• Mariah Destini-Rae Jimenez
• Mary Elizabeth Jimenez
• Mayra Select... Jimenez, MOT, OTR/L
• Monic Jimenez

• Mental Health Counselor in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Mental Health Counselor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.