Individual provider Active NPI

Jacomina Ese Moynihan-Ejaife, MA, LMHC

  • Mental Health Counselor
  • Rochester, NY
National Provider Identifier
1649581257
Registry record updated Feb 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
005688 Issued in NY
Practice address
18 Harvard St
Rochester, NY 14607-2607
Phone
(585) 210-8711
NPI assigned
Jun 29, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2016

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
Mental Health Counselor 101YM0800X 005688 NY Primary

Addresses

Primary practice location

18 Harvard St
Rochester, NY 14607-2607

Mailing address

18 Harvard St
Rochester, NY 14607-2607
Phone (585) 210-8711

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240527000412 NY Practitioner - Mental Health Counselor 3971945650 Practice locations: Rochester, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
005688NYMDSurgical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1277769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454371200000",
    "number": "1649581257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 HARVARD ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146072607",
            "telephone_number": "585-210-8711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 HARVARD ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146072607",
            "telephone_number": "585-210-8711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOYNIHAN-EJAIFE",
        "first_name": "JACOMINA",
        "middle_name": "ESE",
        "name_prefix": "Mrs.",
        "credential": "MA, LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-29",
        "last_updated": "2016-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "005688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.