Jill Matuny Vicino, MS

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH 5187 Issued in FL

Practice address

17566 78TH Rd N
Loxahatchee, FL 33470-2929

Phone

(561) 753-8855

Fax

(561) 383-7864

NPI assigned

Dec 4, 2006

Last updated

Jul 9, 2007By the provider in NPPES

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1861550907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17566 78TH RD. NORTH",
            "city": "LOXAHATCHEE",
            "state": "FL",
            "postal_code": "33470",
            "telephone_number": "561-753-8855",
            "fax_number": "561-383-7864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17566 78TH RD N",
            "city": "LOXAHATCHEE",
            "state": "FL",
            "postal_code": "334702929",
            "telephone_number": "561-753-8855",
            "fax_number": "561-383-7864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICINO",
        "first_name": "JILL",
        "middle_name": "MATUNY",
        "name_prefix": "Mrs.",
        "credential": "MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH 5187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7628234 00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Loxahatchee, FL
• Providers in Loxahatchee, 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 Jul 9, 2007; 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.