Active NPI
Saray Jaquillard, PC-CR
- Professional Counselor
- Toledo, OH
National Provider Identifier
1831590835
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- C1200505
- Practice address
- 1916 N 12TH St
Toledo, OH 43604-5306 - Phone
- (419) 241-8827
- Fax
- (419) 243-1505
- NPI assigned
- Sep 9, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | C1200505 | OH | Primary |
Addresses
Primary practice location
1916 N 12TH St
Toledo, OH 43604-5306
Mailing address
1916 N 12TH St
Toledo, OH 43604-5306
Phone (419) 241-8827
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
| License | State | Type | Specialty |
|---|---|---|---|
| C1200505 | OH | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410220800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1410220800000",
"number": "1831590835",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1916 N 12TH ST",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436045306",
"telephone_number": "419-241-8827",
"fax_number": "419-243-1505"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1916 N 12TH ST",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436045306",
"telephone_number": "419-241-8827",
"fax_number": "419-243-1505"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAQUILLARD",
"first_name": "SARAY",
"credential": "PC-CR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-09-09",
"last_updated": "2014-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OH",
"license": "C1200505",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Toledo, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.