Kimberly Jayne Mendoza, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH16864 Issued in FL

Practice address

1612 Cocoa Bay Blvd
Cocoa, FL 32926-4701

Phone

(321) 508-4903

NPI assigned

Jan 18, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1642464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642464000000",
    "number": "1588315907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2311 STATE ROAD 524 # 303",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329265896",
            "telephone_number": "321-966-8087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1612 COCOA BAY BLVD",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329264701",
            "telephone_number": "321-508-4903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "KIMBERLY",
        "middle_name": "JAYNE",
        "name_prefix": "Ms.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-18",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "FL",
            "license": "MH16864",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH16864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tejas Mehta
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• Judith Mendiola, MA;CT;C-HCLC
• Hannuar Mendoza, RBT
• Kathryn Mendoza, BCBA, ED.D.
• Virginia Y. Mesa, M.D.
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• Tristam Miles
• Janet Elaine Miley, M.D.
• Derek Milligan

• Mental Health Counselor in Cocoa, FL
• Providers in Cocoa, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2022; 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.