Individual provider Active NPI

Emma Jimenez-Manley, LMHC

  • Mental Health Counselor
  • Saint Leo, FL
National Provider Identifier
1508161860
Registry record updated Jun 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH11481 Issued in FL
Practice address
33701 County Road 52
Saint Leo, FL 33574
Phone
(352) 588-7203
NPI assigned
Jan 18, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X IMH 8245 FL
Mental Health Counselor 101YM0800X MH11481 FL Primary

Addresses

Primary practice location

33701 County Road 52
Saint Leo, FL 33574

Mailing address

33701 County Road 52
Mc2216
Saint Leo, FL 33574-6665
Phone (352) 577-8220

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
IMH 8245FLMDMental Health Counselor
MH11481FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Family Preservation Services Past Accepting new patients
Shine Medical Providers PC Past Accepting new patients
Family Preservation Services of Florida, LLC PastSince Dec 17, 2014 Accepting new patients

Organizations & group practices 3

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": "1295308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686787200000",
    "number": "1508161860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33701 COUNTY ROAD 52",
            "address_2": "MC2216",
            "city": "SAINT LEO",
            "state": "FL",
            "postal_code": "335746665",
            "telephone_number": "352-577-8220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33701 COUNTY ROAD 52",
            "city": "SAINT LEO",
            "state": "FL",
            "postal_code": "33574",
            "telephone_number": "352-588-7203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ-MANLEY",
        "first_name": "EMMA",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-18",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH 8245",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH11481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Leo, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2023; 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.