Individual provider Active NPI

Jessica B. Dieppa, LMHC, MCAP, NCC

  • Counselor
  • Miami, FL
National Provider Identifier
1154720555
Registry record updated Feb 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
MH15433 Issued in FL
Practice address
13550 N Kendall Dr Ste 270C
Miami, FL 33186-1513
Phone
(305) 989-0493
NPI assigned
Aug 21, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X MCAP100498 FL
Counselor 101Y00000X MH15433 FL Primary

Addresses

Primary practice location

13550 N Kendall Dr Ste 270C
Miami, FL 33186-1513

Mailing address

15000 SW 149TH Ave
Miami, FL 33196-4416
Phone (305) 989-0493

Other practice location 1

140 NW 59th St
Miami, FL 33127-1218
Phone (305) 759-8888

Other practice location 2

15000 SW 149th Ave
Miami, FL 33196
Phone (305) 989-0493

Other identifiers 1

IdentifierTypeStateIssuer
022974600MedicaidFL

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

State licenses

LicenseStateTypeSpecialty
MH15433FLMDCounselor
MCAP100498FLMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Guided Paths Therapy CurrentSince Feb 9, 2020 Accepting new patients
Banyan Community Health Center, Inc. PastSince Aug 1, 2021 Accepting new patients

Locations

13550 N Kendall Dr
Ste 270C
Miami, FL 33186
Phone (305) 989-0493

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1408579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580947200000",
    "number": "1154720555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15000 SW 149TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331964416",
            "telephone_number": "305-989-0493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13550 N KENDALL DR STE 270C",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331861513",
            "telephone_number": "305-989-0493"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "140 NW 59th St",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331271218",
            "country_code": "US",
            "telephone_number": "305-759-8888",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15000 SW 149th Ave",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "33196",
            "country_code": "US",
            "telephone_number": "305-989-0493",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIEPPA",
        "first_name": "JESSICA",
        "middle_name": "B.",
        "credential": "LMHC, MCAP, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-21",
        "last_updated": "2020-02-06",
        "certification_date": "2020-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "MCAP100498",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "FL",
            "license": "MH15433",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "022974600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2020; 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.