Individual provider Active NPI

Kimberly Sue Jaquess, MA

  • Mental Health Counselor
  • Colorado Springs, CO
National Provider Identifier
1194973792
Registry record updated Jan 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
5080 Mark Dabling Blvd
Colorado Springs, CO 80918-3833
Phone
(719) 532-0151
NPI assigned
Sep 8, 2008
Last updated
Jan 5, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2012

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 NU Primary

Addresses

Primary practice location

5080 Mark Dabling Blvd
Colorado Springs, CO 80918-3833

Mailing address

5080 Mark Dabling Blvd
Colorado Springs, CO 80918-3833
Phone (719) 532-0151

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 Arts

NPI Registry JSON

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

{
    "created_epoch": "1220832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325721600000",
    "number": "1194973792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5080 MARK DABLING BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809183833",
            "telephone_number": "719-532-0151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5080 MARK DABLING BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809183833",
            "telephone_number": "719-532-0151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAQUESS",
        "first_name": "KIMBERLY",
        "middle_name": "SUE",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-08",
        "last_updated": "2012-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2012; 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.