Individual provider Active NPI

Juliet Rose Cain

  • Mental Health Counselor
  • Baltimore, MD
National Provider Identifier
1083023014
Registry record updated Aug 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
10865 Issued in MD
Practice address
5407 N Charles St
Baltimore, MD 21210-2024
Phone
(410) 433-8861
Fax
(410) 433-1249
NPI assigned
Aug 4, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2014

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 10865 MD Primary

Addresses

Primary practice location

5407 N Charles St
Baltimore, MD 21210-2024

Mailing address

5407 N Charles St
Baltimore, MD 21210-2024
Phone (410) 433-8861

Other identifiers 1

IdentifierTypeStateIssuer
12727307OtherMDCAQH

Other names 1

  • Juliet Rose Amendola Other name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
10865MDMDPharmacotherapy Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1407110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407110400000",
    "number": "1083023014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5407 N CHARLES ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212102024",
            "telephone_number": "410-433-8861",
            "fax_number": "410-433-1249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5407 N CHARLES ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212102024",
            "telephone_number": "410-433-8861",
            "fax_number": "410-433-1249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAIN",
        "first_name": "JULIET",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-04",
        "last_updated": "2014-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "10865",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12727307",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIET",
            "last_name": "AMENDOLA",
            "middle_name": "ROSE",
            "credential": "LCSW-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2014; 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.