Individual provider Active NPI

Jesse Unsiog Baleto, MSW

  • Mental Health Counselor
  • Tamuning, GU
National Provider Identifier
1457734022
Registry record updated Jul 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
IMF-140 Issued in GU
Practice address
1244 N Marine Corps Dr
Suite 101
Tamuning, GU 96913-4308
Phone
(671) 647-8262
Fax
(671) 647-8257
NPI assigned
Jul 1, 2015
Last updated
Jul 1, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2015

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 IMF-140 GU Primary

Addresses

Primary practice location

1244 N Marine Corps Dr
Suite 101
Tamuning, GU 96913-4308

Mailing address

244 N. Marine Corps. Drive
Suite 101
Tamuning, GU 96913
Phone (671) 646-6956

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

LicenseStateTypeSpecialty
IMF-140GUMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
American Medical Center, LLC PastSince Aug 1, 2007 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, 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": "1435708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435708800000",
    "number": "1457734022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "244 N. MARINE CORPS. DRIVE",
            "address_2": "SUITE 101",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "96913",
            "telephone_number": "671-646-6956",
            "fax_number": "671-647-3541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1244 N MARINE CORPS DR",
            "address_2": "SUITE 101",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969134308",
            "telephone_number": "671-647-8262",
            "fax_number": "671-647-8257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALETO",
        "first_name": "JESSE",
        "middle_name": "UNSIOG",
        "name_prefix": "Mr.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-01",
        "last_updated": "2015-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GU",
            "license": "IMF-140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tamuning, GU

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2015; 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.