Jacqueline Ann Juarez, LPC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

PLC0000005254 Issued in TN

Practice address

5409 Maryland Way Ste 202
Brentwood, TN 37027-1084

Phone

(615) 373-9955

NPI assigned

Jan 11, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1641859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641859200000",
    "number": "1285385385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5409 MARYLAND WAY STE 202",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370271084",
            "telephone_number": "615-373-9955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5409 MARYLAND WAY STE 202",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370271084",
            "telephone_number": "615-373-9955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUAREZ",
        "first_name": "JACQUELINE",
        "middle_name": "ANN",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-11",
        "last_updated": "2022-01-11",
        "certification_date": "2022-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TN",
            "license": "PLC0000005254",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LPC",
            "identifier": "LPC0000005254",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Doxy.me",
            "affiliation": "N",
            "endpointDescription": "Patient Portal",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5409 Maryland Way Ste 202",
            "city": "Brentwood",
            "state": "TN",
            "country_code": "US",
            "postal_code": "370271084",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jason Jordan, LPC-MHSP
• Kathryn Jordan, LPC-MHSP
• Kelsey Jordan, DC
• Lindsay Jost, APRN FNP-C
• Kayleigh Joyce
• Grayclynn Juckes, CNIM
• Margarete Juliana, LMFT
• Julie H Griggs PHD
• June Diversified Holdings Group Inc
• Ruth Juneau, M.ED., NCC

• Counselor in Brentwood, TN
• Providers in Brentwood, TN by specialty
• Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2022; 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.