Organization Active NPI

Vidaserene Counseling, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fajardo, PR
National Provider Identifier
1093609364
Registry record updated Jun 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
VIDASERENE COUNSELING, LLC
Practice address
410 Ave Monte Sol Ste 14
#2020
Fajardo, PR 00738-5102
Phone
(872) 225-0531
NPI assigned
Jun 3, 2025
Last updated
Jun 3, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2025

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

Authorized official

Name
Jennifer Miranda, LCPC, LMHC, CMHC
Title
Founder/Clinical Therapist
Phone
(941) 799-1383

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

410 Ave Monte Sol Ste 14
#2020
Fajardo, PR 00738-5102

Mailing address

410 Ave Monte Sol Ste 14
Fajardo, PR 00738-5102
Phone (872) 225-0531

National Provider Directory

National Provider Directory

Locations

410 Ave Monte Sol
Ste 14
Fajardo, PR 00738
Phone (872) 225-0531

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1748908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748908800000",
    "number": "1093609364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 AVE MONTE SOL STE 14",
            "city": "FAJARDO",
            "state": "PR",
            "postal_code": "007385102",
            "telephone_number": "872-225-0531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 AVE MONTE SOL STE 14",
            "address_2": "#2020",
            "city": "FAJARDO",
            "state": "PR",
            "postal_code": "007385102",
            "telephone_number": "872-225-0531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIDASERENE COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-03",
        "last_updated": "2025-06-03",
        "certification_date": "2025-05-20",
        "status": "A",
        "authorized_official_last_name": "MIRANDA",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "FOUNDER/CLINICAL THERAPIST",
        "authorized_official_telephone_number": "941-799-1383",
        "authorized_official_credential": "LCPC, LMHC, CMHC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fajardo, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2025; 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.