Active NPI
Jessenia Rivera
- Mental Health Counselor
- Eatontown, NJ
National Provider Identifier
1215577648
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 37AC00504000
- Practice address
- 117 Highway 35 Ste 2
Eatontown, NJ 07724-1886 - Phone
- (732) 982-2888
- Fax
- (847) 859-5885
- NPI assigned
- Jan 14, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 37AC00504000 | NJ | Primary |
Addresses
Primary practice location
117 Highway 35 Ste 2
Eatontown, NJ 07724-1886
Mailing address
175 E Hawthorn Pkwy Ste 235
Vernon Hills, IL 60061-1454
Phone (847) 868-3435
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
| License | State | Type | Specialty |
|---|---|---|---|
| 37AC00504000 | NJ | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1578960000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578960000000",
"number": "1215577648",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "175 E HAWTHORN PKWY STE 235",
"city": "VERNON HILLS",
"state": "IL",
"postal_code": "600611454",
"telephone_number": "847-868-3435",
"fax_number": "847-859-5885"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "117 HIGHWAY 35 STE 2",
"city": "EATONTOWN",
"state": "NJ",
"postal_code": "077241886",
"telephone_number": "732-982-2888",
"fax_number": "847-859-5885"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERA",
"first_name": "JESSENIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-01-14",
"last_updated": "2020-01-14",
"certification_date": "2020-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NJ",
"license": "37AC00504000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eatontown, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.