Individual provider Active NPI

Madeline Jimenez, MA

  • Mental Health Counselor
  • Rio Piedras, PR
National Provider Identifier
1083814842
Registry record updated Jul 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
2257 Issued in PR
Practice address
Cond San Ignacio
Apto. 1405a
Rio Piedras, PR 00921-3814
Phone
(787) 222-1053
Fax
(787) 763-9693
NPI assigned
Jul 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2007

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 2257 PR Primary

Addresses

Primary practice location

Cond San Ignacio
Apto. 1405a
Rio Piedras, PR 00921-3814

Mailing address

Cond San Ignacio
Apto. 1405a
Rio Piedras, PR 00921-3814
Phone (787) 222-1053

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)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
2257PRMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1184889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184889600000",
    "number": "1083814842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "COND SAN IGNACIO",
            "address_2": "APTO. 1405A",
            "city": "RIO PIEDRAS",
            "state": "PR",
            "postal_code": "009213814",
            "telephone_number": "787-222-1053",
            "fax_number": "787-763-9693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "COND SAN IGNACIO",
            "address_2": "APTO. 1405A",
            "city": "RIO PIEDRAS",
            "state": "PR",
            "postal_code": "009213814",
            "telephone_number": "787-222-1053",
            "fax_number": "787-763-9693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "MADELINE",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-20",
        "last_updated": "2007-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "PR",
            "license": "2257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Piedras, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2007; 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.