Jessica Heredia, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH14227 Issued in FL

Practice address

1176 Cypress Glen Cir
Kissimmee, FL 34741-7560

Phone

(352) 394-0573

NPI assigned

Jul 10, 2012

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Neumind Wellness Group LLC

  • Community/Behavioral Health Agency
  • Clermont, FL
  • NPI 1396101697
  Medicare reassignment NPD

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

{
    "created_epoch": "1341878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702944000000",
    "number": "1811252307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4571 HOLSTEIN ST",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347729223",
            "telephone_number": "407-860-4664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1176 CYPRESS GLEN CIR",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347417560",
            "telephone_number": "352-394-0573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEREDIA",
        "first_name": "JESSICA",
        "name_prefix": "Mrs.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-10",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH14227",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED MENTAL HEALTH COUNSELOR LICENSE NUMBER",
            "identifier": "LMHC14227",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015686500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carla Henriquez Marques, RBT
• Jessica Klein Henriquez
• Richard Henriquez
• Marcia M Henry, LPN
• Noel Henry, O.D.
• Jose Angel Heredia, RN NURSE
• Lizeth Alejandra Heredia, FNP-C
• Yrene Heredia
• Mark Hermano, D.D.S.
• Marco Hernandez Alberdi, MD

• Mental Health Counselor in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.