Jacqueline K Mendoza, LCSW, ACSW,LCDC (TX)

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

32084 Issued in TX

Practice address

4615 Government St BLDG 1
Baton Rouge, LA 70806-5922

Phone

(225) 922-0478

Fax

(225) 922-2658

NPI assigned

Dec 30, 2006

Last updated

Jan 4, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Capital Area Human Services District School Based Services

  • Adolescent and Children Mental Health Clinic/Center
  • Baton Rouge, LA
  • NPI 1326464637
  NPD (past)

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

{
    "created_epoch": "1167436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325635200000",
    "number": "1417013574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 S EUGENE ST",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708065478",
            "telephone_number": "225-931-9981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4615 GOVERNMENT ST BLDG 1",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708065922",
            "telephone_number": "225-922-0478",
            "fax_number": "225-922-2658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "JACQUELINE",
        "middle_name": "K",
        "credential": "LCSW, ACSW,LCDC (TX)",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-30",
        "last_updated": "2012-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "9979",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "0189",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "32084",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0079KX",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN HEALTH SERVICES",
            "identifier": "258450000",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2230312",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN",
            "identifier": "309302",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH NETWORK",
            "identifier": "2195773",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julie Mendes, M.ED, BCBA
• Lynnette A Mendez
• Mending the Soul Restoration of the Mind Body and Soul (Mending the Soul RMBS)
• Thomas Michael Mendler, M.D.
• Carlos Mendoza, FNP
• Kelly Chambers Mendoza
• Steve Allen Mengarelli, O.D.
• Natalee A Menge, AUD, CCC-A
• Prem Kumar Menon, M. D.
• Vimla Menon, M. D.

• Clinical Social Worker in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Clinical Social Worker in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2012; 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.