Individual provider Active NPI

Jana Irene Hernandez

  • Mental Health Counselor
  • Kendallville, IN
National Provider Identifier
1902489560
Registry record updated May 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
39003960A Issued in IN
Practice address
1930 Dowling St
Kendallville, IN 46755-9436
Phone
(260) 347-4400
NPI assigned
May 2, 2021
Last updated
May 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2021

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 39003960A IN Primary

Addresses

Primary practice location

1930 Dowling St
Kendallville, IN 46755-9436

Mailing address

220 S Main St
Kendallville, IN 46755-1718
Phone (260) 347-2453

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240202003384 IN Practitioner - Mental Health Counselor 3476996786 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeastern Center IncGroup PAC ID 6709795636, 24 clinicians

Practice addresses (Care Compare)

1930 Dowling St
Kendallville, IN 46755-9436
Phone (260) 347-4400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
39003960AINMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Northeastern Center, Inc CurrentSince Jan 1, 2024 Accepting new patients
Northeastern Center Inc CurrentSince Jan 1, 2024 Accepting new patients

Locations

1930 Dowling St
Kendallville, IN 46755
Phone (260) 347-4400

220 S Main St
Kendallville, IN 46755
Phone (219) 347-4400

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1619913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619913600000",
    "number": "1902489560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 S MAIN ST",
            "city": "KENDALLVILLE",
            "state": "IN",
            "postal_code": "467551718",
            "telephone_number": "260-347-2453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 DOWLING ST",
            "city": "KENDALLVILLE",
            "state": "IN",
            "postal_code": "467559436",
            "telephone_number": "260-347-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "JANA",
        "middle_name": "IRENE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-02",
        "last_updated": "2021-05-02",
        "certification_date": "2021-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39003960A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kendallville, IN

Sources for this page

Verify at the official NPI Registry.