Individual provider Active NPI

Tia Jimenez

  • Mental Health Counselor
  • Atlanta, GA
National Provider Identifier
1174067789
Registry record updated Sep 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
010264 Issued in NY
Practice address
2870 Peachtree Rd NW # 915-1980
Atlanta, GA 30305-2918
Phone
(718) 938-6896
NPI assigned
Dec 15, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 668 FL
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X 012731 GA
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 010264 NY Primary

Addresses

Primary practice location

2870 Peachtree Rd NW # 915-1980
Atlanta, GA 30305-2918

Mailing address

2870 Peachtree Rd NW # 915-1980
Atlanta, GA 30305-2918
Phone (718) 938-6896

Other practice location 1

511 6th Ave # 7259
New York, NY 10011-8436
Phone (718) 938-6896

Other practice location 2

7901 4th St N Ste 300
St Petersburg, FL 33702-4399
Phone (718) 938-6896

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
668FLMDMental Health Counselor
010264NYMDMental Health Counselor
012731GAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Tia Jimenez Therapy Inc. Mental Health Current Accepting new patients

Locations

7901 4th St N
Ste 300
St Petersburg, FL 33702
Phone (305) 204-3616

2870 Peachtree Rd NW
Atlanta, GA 30305
Phone (404) 410-0224

511 6th Ave
#7259
New York, NY 10011
Phone (347) 201-3165

Organizations & group practices 1

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": "1481760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1174067789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2870 PEACHTREE RD NW # 915-1980",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303052918",
            "telephone_number": "718-938-6896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2870 PEACHTREE RD NW # 915-1980",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303052918",
            "telephone_number": "718-938-6896"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "511 6th Ave # 7259",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100118436",
            "country_code": "US",
            "telephone_number": "718-938-6896",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7901 4th St N Ste 300",
            "address_purpose": "LOCATION",
            "city": "St Petersburg",
            "state": "FL",
            "postal_code": "337024399",
            "country_code": "US",
            "telephone_number": "718-938-6896",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "TIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-15",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "668",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "012731",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "010264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 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.