Individual provider Active NPI

Jillian Pena

  • Mental Health Counselor
  • Red Hook, NY
National Provider Identifier
1811827645
Registry record updated May 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
122925 Issued in NY
Practice address
112 Starbarrack Rd
Red Hook, NY 12571-2251
Phone
(505) 379-5320
NPI assigned
May 22, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 122925 NY Primary

Addresses

Primary practice location

112 Starbarrack Rd
Red Hook, NY 12571-2251

Mailing address

112 Starbarrack Rd
Red Hook, NY 12571-2251
Phone (505) 379-5320

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

LicenseStateTypeSpecialty
122925NYMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1779408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779408000000",
    "number": "1811827645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 STARBARRACK RD",
            "city": "RED HOOK",
            "state": "NY",
            "postal_code": "125712251",
            "telephone_number": "505-379-5320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 STARBARRACK RD",
            "city": "RED HOOK",
            "state": "NY",
            "postal_code": "125712251",
            "telephone_number": "505-379-5320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA",
        "first_name": "JILLIAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-05-22",
        "last_updated": "2026-05-22",
        "certification_date": "2026-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "122925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Hook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2026; 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.