Individual provider Active NPI

Joanna Saint Jacques, LCSW

  • Mental Health Counselor
  • Riviera Beach, FL
National Provider Identifier
1487120713
Registry record updated Mar 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
2001 W Blue Heron Blvd
Riviera Beach, FL 33404
Phone
(561) 841-3500
NPI assigned
Oct 13, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2022

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 Primary

Addresses

Primary practice location

2001 W Blue Heron Blvd
Riviera Beach, FL 33404

Mailing address

887 Cotton Bay Dr W Apt 203
West Palm Beach, FL 33406-9086
Phone (954) 638-7816

Other practice location 1

2431 Aloma Ave Ste 255
Winter Park, FL 32792-2541
Phone (321) 352-1715

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL N/A

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20220913000166 FL Practitioner - Clinical Social Worker 8426433475 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Exceptional Services Group, LLCGroup PAC ID 1658403720, 13 clinicians

Practice addresses (Care Compare)

9250 Glades Rd
Suite 111
Boca Raton, FL 33434-3958
Phone (561) 852-0910

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Exceptional Services Group, LLC CurrentSince Aug 10, 2022 Accepting new patients

Locations

9250 Glades Rd
Ste 111
Boca Raton, FL 33434
Phone (561) 479-2880

9070 Kimberly Blvd
Ste 50
Boca Raton, FL 33434
Phone (561) 852-0910

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1539388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646611200000",
    "number": "1487120713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "887 COTTON BAY DR W APT 203",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334069086",
            "telephone_number": "954-638-7816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 W BLUE HERON BLVD",
            "city": "RIVIERA BEACH",
            "state": "FL",
            "postal_code": "33404",
            "telephone_number": "561-841-3500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2431 Aloma Ave Ste 255",
            "address_purpose": "LOCATION",
            "city": "Winter Park",
            "state": "FL",
            "postal_code": "327922541",
            "country_code": "US",
            "telephone_number": "321-352-1715",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAINT JACQUES",
        "first_name": "JOANNA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-13",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "N/A",
            "affiliation": "N",
            "address_1": "2001 W Blue Heron Blvd",
            "city": "Riviera Beach",
            "state": "FL",
            "country_code": "US",
            "postal_code": "334045003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Riviera Beach, FL

Sources for this page

Verify at the official NPI Registry.