Active NPI
Jimmy Garcia, QMHP-R
- Mental Health Counselor
- Madras, OR
National Provider Identifier
1740751619
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 22-QMHP-R-R-1727
- Practice address
- 850 SW 4TH St Ste 302
Madras, OR 97741-9629 - Phone
- (541) 475-6575
- Fax
- (541) 475-6196
- NPI assigned
- Dec 17, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 22-QMHP-R-R-1727 | OR | Primary |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | R1325701018 | CA |
Addresses
Primary practice location
850 SW 4TH St Ste 302
Madras, OR 97741-9629
Mailing address
850 SW 4TH St Ste 302
Madras, OR 97741-9629
Phone (541) 475-6575
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 |
|---|---|---|---|
| R1325701018 | CA | MD | Addiction (Substance Use Disorder) Counselor |
| 22-QMHP-R-R-1727 | OR | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1545004800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675641600000",
"number": "1740751619",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "850 SW 4TH ST STE 302",
"city": "MADRAS",
"state": "OR",
"postal_code": "977419629",
"telephone_number": "541-475-6575",
"fax_number": "541-475-6196"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "850 SW 4TH ST STE 302",
"city": "MADRAS",
"state": "OR",
"postal_code": "977419629",
"telephone_number": "541-475-6575",
"fax_number": "541-475-6196"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARCIA",
"first_name": "JIMMY",
"credential": "QMHP-R",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-12-17",
"last_updated": "2023-02-06",
"certification_date": "2023-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OR",
"license": "22-QMHP-R-R-1727",
"primary": true
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "R1325701018",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madras, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 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.