Active NPI
Marisa M Jelu, PSY.D
- Behavior Analyst
- Miami, FL
National Provider Identifier
1962771832
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 8785 SW 165TH Ave
Suite #106-C
Miami, FL 33193-5826 - Phone
- (786) 206-6500
- Fax
- (786) 206-4702
- NPI assigned
- Dec 22, 2011
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 4129 | PR | |
| Mental Health Counselor | 101YM0800X | 4129 | PR | |
| Behavior Analyst | 103K00000X | FL | Primary |
Addresses
Primary practice location
8785 SW 165TH Ave
Suite #106-C
Miami, FL 33193-5826
Mailing address
8874 W Flagler St
Apt. 105
Miami, FL 33174-3982
Phone (305) 853-6282
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 |
|---|---|---|---|
| 4129 | PR | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1324512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1476489600000",
"number": "1962771832",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8874 W FLAGLER ST",
"address_2": "APT. 105",
"city": "MIAMI",
"state": "FL",
"postal_code": "331743982",
"telephone_number": "305-853-6282"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8785 SW 165TH AVE",
"address_2": "SUITE #106-C",
"city": "MIAMI",
"state": "FL",
"postal_code": "331935826",
"telephone_number": "786-206-6500",
"fax_number": "786-206-4702"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JELU",
"first_name": "MARISA",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "PSY.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-12-22",
"last_updated": "2016-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PR",
"license": "4129",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "PR",
"license": "4129",
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "FL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.