Andres Nicholas Jaramillo, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPC-17933 Issued in AZ

Practice address

4131 N 24TH St Ste B102
Phoenix, AZ 85016-6231

Phone

(480) 882-4545

Fax

(602) 381-1341

NPI assigned

Jan 30, 2012

Last updated

Jan 27, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1327881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674777600000",
    "number": "1861764466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7500 N DREAMY DRAW DR STE 145",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850204668",
            "telephone_number": "480-882-4545",
            "fax_number": "480-882-5814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4131 N 24TH ST STE B102",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850166231",
            "telephone_number": "480-882-4545",
            "fax_number": "602-381-1341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARAMILLO",
        "first_name": "ANDRES",
        "middle_name": "NICHOLAS",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-01-30",
        "last_updated": "2023-01-27",
        "certification_date": "2023-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LPC-17933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "506403",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jena C Jaquez, RBT
• Flor Jara Castaneda
• Ryan Renee' Jara-Bersch, RN
• Christian Jara, MD
• Mohammad M Jaradat, MD
• Cecelia Jaramillo
• Ernest Jaramillo
• Keith Alan Jarbo, M.D.
• Douglas Seymour Jardine Jr., PHD, LMFT
• Mathena Jardine, NP

• Mental Health Counselor in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Mental Health Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2023; 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.