Jacqueline D Tejada, BS

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

ISW10217 Issued in FL

Practice address

654 NE 9TH PL
Homestead, FL 33030-4934

Phone

(305) 248-3488

NPI assigned

Dec 7, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

State licenses

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

{
    "created_epoch": "1354838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599782400000",
    "number": "1053656637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "654 NE 9TH PL",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330304934",
            "telephone_number": "305-248-3488",
            "fax_number": "305-248-6558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "654 NE 9TH PL",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330304934",
            "telephone_number": "305-248-3488"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "31 N Krome Ave",
            "address_purpose": "LOCATION",
            "city": "Homestead",
            "state": "FL",
            "postal_code": "330306014",
            "country_code": "US",
            "telephone_number": "786-481-5909",
            "fax_number": "786-481-5908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TEJADA",
        "first_name": "JACQUELINE",
        "middle_name": "D",
        "credential": "BS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-07",
        "last_updated": "2020-09-11",
        "certification_date": "2020-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "ISW10217",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA DEPARTMENT OF HEALTH",
            "identifier": "ISW10217",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Carolina Tejeda
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• Dario Tejera
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• Mental Health Counselor in Homestead, FL
• Providers in Homestead, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2020; 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.