Individual provider Active NPI

Jacki Elyse Rodriguez

  • Mental Health Counselor
  • Mount Vernon, NY
National Provider Identifier
1114602133
Registry record updated Jun 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
138 S Columbus Ave FL 1
Mount Vernon, NY 10553-1337
Phone
(347) 398-6993
NPI assigned
Jun 19, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2023

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

138 S Columbus Ave FL 1
Mount Vernon, NY 10553-1337

Mailing address

138 S Columbus Ave FL 1
Mount Vernon, NY 10553-1337
Phone (347) 398-6993

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1687132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687132800000",
    "number": "1114602133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 S COLUMBUS AVE FL 1",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105531337",
            "telephone_number": "347-398-6993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 S COLUMBUS AVE FL 1",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105531337",
            "telephone_number": "347-398-6993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "JACKI",
        "middle_name": "ELYSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-19",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, NY

Sources for this page

Verify at the official NPI Registry.