Individual provider Active NPI

Jacquline Jaramillo

  • Professional Counselor
  • Pueblo, CO
National Provider Identifier
1780911487
Registry record updated Jun 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC.0016295 Issued in CO
Practice address
1026 W Abriendo Ave
Pueblo, CO 81004-1128
Phone
(719) 545-2746
Fax
(719) 545-4100
NPI assigned
Nov 17, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2020

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
Professional Counselor 101YP2500X LPC.0016295 CO Primary

Addresses

Primary practice location

1026 W Abriendo Ave
Pueblo, CO 81004-1128

Mailing address

41 Montebello Rd Ste 204
Pueblo, CO 81001-1379
Phone (719) 545-2746

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC.0016295COMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1258416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592956800000",
    "number": "1780911487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 MONTEBELLO RD STE 204",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810011379",
            "telephone_number": "719-545-2746",
            "fax_number": "719-545-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1026 W ABRIENDO AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810041128",
            "telephone_number": "719-545-2746",
            "fax_number": "719-545-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARAMILLO",
        "first_name": "JACQULINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-17",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "LPC.0016295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2020; 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.