Jose Enrique Negrete, LSW
Individual provider Active NPI Mental Health Counselor · Saint John, IN
NPI 1609592377 · NPPES record last updated Oct 14, 2022
Key facts
- NPI
- 1609592377
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 150.108975 (IL)
- Practice address
- 10396 Redwood Dr
Saint John, IN 46373-8783 - Phone
- (219) 730-9906
- NPI assigned
- Oct 14, 2022
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 150.108975 | IL | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 150.108975 | IL | Yes |
Addresses
Primary practice location
10396 Redwood Dr
Saint John, IN 46373-8783
Mailing address
10396 Redwood Dr
Saint John, IN 46373-8783
Phone (219) 730-9906
NPI Registry JSON
{
"created_epoch": "1665705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665705600000",
"number": "1609592377",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10396 REDWOOD DR",
"city": "SAINT JOHN",
"state": "IN",
"postal_code": "463738783",
"telephone_number": "219-730-9906"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10396 REDWOOD DR",
"city": "SAINT JOHN",
"state": "IN",
"postal_code": "463738783",
"telephone_number": "219-730-9906"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEGRETE",
"first_name": "JOSE",
"middle_name": "ENRIQUE",
"credential": "LSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-10-14",
"last_updated": "2022-10-14",
"certification_date": "2022-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IL",
"license": "150.108975",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint John, IN
- Myeyedr Optometry of Indiana, LLC
- Saba Najamuddin
- Nanette Stokes Family Counseling Center
- Guadalupe Navarro
- NBHT Indiana
- Jane Neidy
- Tamara A Nicksic
- Mia Nisle
- Northshore Health Centers, Inc.
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All providers in Saint John, IN · Mental Health Counselor in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 14, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.