Active NPI
Jose Javier Sierra, PSY.D.
- Mental Health Counselor
- Orlando, FL
National Provider Identifier
1396731378
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MH 9319
- Practice address
- 8530 Suburban Dr.
Orlando, FL 32825 - Phone
- (407) 482-7500
- Fax
- (407) 482-7575
- NPI assigned
- Sep 23, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MH 9319 | FL | Primary |
| Professional Counselor | 101YP2500X | 180005069 | IL | |
| Marriage & Family Therapist | 106H00000X | MT 2284 | FL |
Addresses
Primary practice location
8530 Suburban Dr.
Orlando, FL 32825
Mailing address
8401 Valencia College LN
Orlando, FL 32825-3246
Phone (407) 482-7500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 364333972 | Other | IL | TAX IDENTIFICATION NO. |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 1, 2024 through Apr 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MH 9319 | FL | MD | Mental Health Counselor |
| 180005069 | IL | MD | Professional Counselor |
| MT 2284 | FL | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127433600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1285804800000",
"number": "1396731378",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8401 VALENCIA COLLEGE LN",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328253246",
"telephone_number": "407-482-7500",
"fax_number": "407-482-7575"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8530 SUBURBAN DR.",
"city": "ORLANDO",
"state": "FL",
"postal_code": "32825",
"telephone_number": "407-482-7500",
"fax_number": "407-482-7575"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIERRA",
"first_name": "JOSE",
"middle_name": "JAVIER",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-23",
"last_updated": "2010-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "MH 9319",
"primary": true
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "180005069",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "FL",
"license": "MT 2284",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX IDENTIFICATION NO.",
"identifier": "364333972",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.