Individual provider Active NPI

Jeannette C Rodriguez Leon, MS MBA

  • Mental Health Counselor
  • Plantation, FL
National Provider Identifier
1093960924
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
IMH1097 Issued in FL
Practice address
9861 NW 5TH PL
Plantation, FL 33324-7042
Phone
(954) 253-7427
Fax
(954) 473-0211
NPI assigned
Nov 19, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 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 IMH1097 FL Primary

Addresses

Primary practice location

9861 NW 5TH PL
Plantation, FL 33324-7042

Mailing address

9861 NW 5TH PL
Plantation, FL 33324-7042
Phone (954) 253-7427

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 Business Administration, Master of Science

State licenses

LicenseStateTypeSpecialty
IMH1097FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1227052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1093960924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9861 NW 5TH PL",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333247042",
            "telephone_number": "954-253-7427",
            "fax_number": "954-473-0211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9861 NW 5TH PL",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333247042",
            "telephone_number": "954-253-7427",
            "fax_number": "954-473-0211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ LEON",
        "first_name": "JEANNETTE",
        "middle_name": "C",
        "credential": "MS MBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-19",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH1097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2024; 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.