Individual provider Active NPI

Jachael Holmes-Enriquez

  • Mental Health Counselor
  • Hyattsville, MD
National Provider Identifier
1609459809
Registry record updated Jul 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
8181 Professional PL Ste 200
Hyattsville, MD 20785-7219
Phone
(301) 306-4590
NPI assigned
May 4, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2023

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

8181 Professional PL Ste 200
Hyattsville, MD 20785-7219

Mailing address

514 Short Curve Rd
Glen Burnie, MD 21061-5143
Phone (240) 472-3388

Other practice location 1

4901 Collington Rd
Bowie, MD 20715-2537
Phone (301) 805-2660

Other names 1

  • Jachael Holmes Former name

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

Practice roles

OrganizationSpecialtyStatusNew patients
Interdynamics, Inc. CurrentSince Aug 6, 2023 Accepting new patients
Interdynamics, Inc. PastSince Aug 6, 2023 Accepting new patients

Locations

8181 Professional Pl
Ste 200
Landover, MD 20785
Phone (301) 306-4590

Organizations & group practices 2

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": "1620086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1609459809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 SHORT CURVE RD",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210615143",
            "telephone_number": "240-472-3388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8181 PROFESSIONAL PL STE 200",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207857219",
            "telephone_number": "301-306-4590"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4901 Collington Rd",
            "address_purpose": "LOCATION",
            "city": "Bowie",
            "state": "MD",
            "postal_code": "207152537",
            "country_code": "US",
            "telephone_number": "301-805-2660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLMES-ENRIQUEZ",
        "first_name": "JACHAEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-04",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACHAEL",
            "last_name": "HOLMES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hyattsville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 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.