Individual provider Active NPI

Tiffany Jimbo, LPC

  • Mental Health Counselor
  • Frisco, TX
National Provider Identifier
1821789355
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
87105 Issued in TX
Practice address
5300 Town and Country Blvd Ste 155
Frisco, TX 75034-6949
Phone
(214) 997-3629
NPI assigned
May 16, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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 87105 TX Primary

Addresses

Primary practice location

5300 Town and Country Blvd Ste 155
Frisco, TX 75034-6949

Mailing address

5300 Town and Country Blvd Ste 155
Frisco, TX 75034-6949
Phone (214) 997-3629

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
87105TXMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1684195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1821789355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 TOWN AND COUNTRY BLVD STE 155",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750346949",
            "telephone_number": "214-997-3629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 TOWN AND COUNTRY BLVD STE 155",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750346949",
            "telephone_number": "214-997-3629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMBO",
        "first_name": "TIFFANY",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-16",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "87105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frisco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2024; 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.