Individual provider Active NPI

Richard Jimenez, LMHC, CASAC

  • Mental Health Counselor
  • Depew, NY
National Provider Identifier
1073802823
Registry record updated Jun 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
5813 Transit Rd
Depew, NY 14043-2819
Phone
(716) 281-0102
Fax
(716) 989-4704
NPI assigned
Apr 1, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2024

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 Primary

Addresses

Primary practice location

5813 Transit Rd
Depew, NY 14043-2819

Mailing address

5813 Transit Rd
Depew, NY 14043-2819
Phone (716) 281-0102

Other names 1

  • Ricardo Jimenez Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20240725000113 NY Practitioner - Mental Health Counselor 3274079348 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
005579NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Hillview Mental Health Counseling PLLC Addiction (Substance Use Disorder) CurrentSince Jul 10, 2024 Accepting new patients

Locations

5813 Transit Rd
Depew, NY 14043
Phone (716) 281-0102

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1301616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719446400000",
    "number": "1073802823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5813 TRANSIT RD",
            "city": "DEPEW",
            "state": "NY",
            "postal_code": "140432819",
            "telephone_number": "716-281-0102",
            "fax_number": "716-989-4704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5813 TRANSIT RD",
            "city": "DEPEW",
            "state": "NY",
            "postal_code": "140432819",
            "telephone_number": "716-281-0102",
            "fax_number": "716-989-4704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "RICHARD",
        "credential": "LMHC, CASAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-01",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RICARDO",
            "last_name": "JIMENEZ",
            "credential": "LMHC, CASAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Depew, NY

Sources for this page

Verify at the official NPI Registry.