Active NPI
Lauren K St Jacques, LMFT
- Mental Health Counselor
- Riverside, CA
National Provider Identifier
1720622814
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 116109
- Practice address
- 1450 Iowa Ave Ste 210
Riverside, CA 92507-0508 - Phone
- (951) 203-3276
- NPI assigned
- Oct 31, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 116109 | CA | Primary |
Addresses
Primary practice location
1450 Iowa Ave Ste 210
Riverside, CA 92507-0508
Mailing address
1450 Iowa Ave Ste 210
Riverside, CA 92507-0508
Phone (951) 203-3276
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | Riverside | Direct |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 116109 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1572480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676332800000",
"number": "1720622814",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1450 IOWA AVE STE 210",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925070508",
"telephone_number": "951-203-3276"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1450 IOWA AVE STE 210",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925070508",
"telephone_number": "951-203-3276"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ST JACQUES",
"first_name": "LAUREN",
"middle_name": "K",
"name_prefix": "Mrs.",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-10-31",
"last_updated": "2023-02-14",
"certification_date": "2021-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "116109",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "Riverside",
"affiliation": "N",
"endpointDescription": "Email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Riverside",
"address_1": "1450 Iowa Ave Ste 210",
"city": "Riverside",
"state": "CA",
"country_code": "US",
"postal_code": "925070508",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
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- Sri Gorty M.D. Inc
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- Victoria Sheree St Martin, DO
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- St. Jude Medical Transportation
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 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.