Active NPI
Jesucita Morales Vasques
- Mental Health Counselor
- Dallas, OR
National Provider Identifier
1265675458
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 182 SW Academy St
Dallas, OR 97338-1996 - Phone
- (503) 623-9289
- Fax
- (503) 831-1726
- NPI assigned
- Apr 17, 2009
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | A2375 | OR | |
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
182 SW Academy St
Dallas, OR 97338-1996
Mailing address
PO Box 20123
Keizer, OR 97307-0123
Phone (503) 400-3550
Other practice location 1
85 N 12th Ave
Cornelius, OR 97113-9029
Phone (503) 359-5564
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 |
|---|---|---|---|
| A2375 | OR | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Virginia Garcia Memorial Health Center | Past | Accepting new patients |
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.
-
- Federally Qualified Health Center (FQHC)
- Hillsboro, OR
- NPI 1457229197
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1239926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731024000000",
"number": "1265675458",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 20123",
"city": "KEIZER",
"state": "OR",
"postal_code": "973070123",
"telephone_number": "503-400-3550",
"fax_number": "503-837-0095"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "182 SW ACADEMY ST",
"city": "DALLAS",
"state": "OR",
"postal_code": "973381996",
"telephone_number": "503-623-9289",
"fax_number": "503-831-1726"
}
],
"practiceLocations": [
{
"address_1": "85 N 12th Ave",
"address_purpose": "LOCATION",
"city": "Cornelius",
"state": "OR",
"postal_code": "971139029",
"country_code": "US",
"telephone_number": "503-359-5564",
"fax_number": "503-359-8532",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MORALES VASQUES",
"first_name": "JESUCITA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-04-17",
"last_updated": "2024-11-08",
"certification_date": "2024-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OR",
"license": "A2375",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.