Individual provider Active NPI

Jesika Ortiz Bueno, LCMHC

  • Mental Health Counselor
  • Manchester, NH
National Provider Identifier
1356188874
Registry record updated Aug 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
4702 Issued in NH
Practice address
66 Hanover St Ste 200
Manchester, NH 03101-2230
Phone
(978) 226-3595
NPI assigned
Jul 11, 2024
Last updated
Aug 20, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2026

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 4702 NH Primary

Addresses

Primary practice location

66 Hanover St Ste 200
Manchester, NH 03101-2230

Mailing address

66 Hanover St Ste 200
Manchester, NH 03101-2230
Phone (978) 226-3595

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240808002436 NH Practitioner - Mental Health Counselor 4183161094 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wanderlust Therapeutic Services PLLCGroup PAC ID 7012322753, 13 clinicians
Nicole Sublette Counseling Services LLCGroup PAC ID 3274067327, 2 clinicians

Practice addresses (Care Compare)

400 Amherst St
Suite 200
Nashua, NH 03063-4223
Phone (603) 889-3553

66 Hanover St
Suite 200
Manchester, NH 03101-2230
Phone (603) 787-3151

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4702NHMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Wanderlust Therapeutic Services, PLLC CurrentSince Jul 30, 2024 Accepting new patients

Locations

889 Elm St
Manchester, NH 03101
Phone (603) 889-3553

400 Amherst St
Ste 200
Nashua, NH 03063
Phone (603) 205-3623

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1720656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787184000000",
    "number": "1356188874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 HANOVER ST STE 200",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031012230",
            "telephone_number": "978-226-3595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 HANOVER ST STE 200",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031012230",
            "telephone_number": "978-226-3595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTIZ BUENO",
        "first_name": "JESIKA",
        "credential": "LCMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-11",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NH",
            "license": "4702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

Verify at the official NPI Registry.