Individual provider Active NPI

Andraw Jestina Pierre, M.S

  • Mental Health Counselor
  • Riviera Beach, FL
National Provider Identifier
1639420342
Registry record updated Sep 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
IMH7148 Issued in FL
Practice address
2001 Blue Heron Blvd W
Riviera Beach, FL 33404-5003
Phone
(561) 841-3500
Fax
(561) 844-4753
NPI assigned
Sep 21, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2012

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 IMH7148 FL Primary

Addresses

Primary practice location

2001 Blue Heron Blvd W
Riviera Beach, FL 33404-5003

Mailing address

9253 Bloomfield Dr
Palm Beach Gardens, FL 33410-5933
Phone (561) 339-0620

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
IMH7148FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1348185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348185600000",
    "number": "1639420342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9253 BLOOMFIELD DR",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334105933",
            "telephone_number": "561-339-0620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 BLUE HERON BLVD W",
            "city": "RIVIERA BEACH",
            "state": "FL",
            "postal_code": "334045003",
            "telephone_number": "561-841-3500",
            "fax_number": "561-844-4753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIERRE",
        "first_name": "ANDRAW",
        "middle_name": "JESTINA",
        "name_prefix": "Mrs.",
        "credential": "M.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-21",
        "last_updated": "2012-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH7148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riviera Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2012; 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.