Active NPI
Jill Laquidara, MA
- Counselor
- Sacramento, CA
National Provider Identifier
1811414873
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 2230 Stockton Blvd
Sacramento, CA 95817-1353 - Phone
- (916) 734-0515
- NPI assigned
- Aug 29, 2017
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Case Manager/Care Coordinator | 171M00000X | |||
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
2230 Stockton Blvd
Sacramento, CA 95817-1353
Mailing address
35 Market St
Lowell, MA 01852-6245
Other practice location 1
35 Market St
Lowell, MA 01852-6245
Phone (978) 459-0389
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
- Credentials
- Master of Arts
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bridgewell, Inc | Past | Accepting new patients | |
| Bridgewell Counseling | Mental Health | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Mental Health Counselor
- Lowell, MA
- NPI 1922316058
-
- Community/Behavioral Health Agency
- Lowell, MA
- NPI 1033262860
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1538006400000",
"number": "1811414873",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35 MARKET ST",
"city": "LOWELL",
"state": "MA",
"postal_code": "018526245"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2230 STOCKTON BLVD",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958171353",
"telephone_number": "916-734-0515"
}
],
"practiceLocations": [
{
"address_1": "35 Market St",
"address_purpose": "LOCATION",
"city": "Lowell",
"state": "MA",
"postal_code": "018526245",
"country_code": "US",
"telephone_number": "978-459-0389",
"fax_number": "978-459-7642",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LAQUIDARA",
"first_name": "JILL",
"credential": "MA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-08-29",
"last_updated": "2018-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.