Individual provider Active NPI

Tereza Jelenova, MA, LMHCA

  • Mental Health Counselor
  • Edmonds, WA
National Provider Identifier
1962874388
Registry record updated Oct 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MC60574012 Issued in WA
Practice address
316 Main St
Suite B
Edmonds, WA 98020-3197
Phone
(360) 951-6051
NPI assigned
Oct 25, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2015

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 MC60574012 WA Primary

Addresses

Primary practice location

316 Main St
Suite B
Edmonds, WA 98020-3197

Mailing address

314 W Galer St
Seattle, WA 98119-3393
Phone (360) 951-6051

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
MC60574012WAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1445731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445731200000",
    "number": "1962874388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 W GALER ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981193393",
            "telephone_number": "360-951-6051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 MAIN ST",
            "address_2": "SUITE B",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980203197",
            "telephone_number": "360-951-6051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JELENOVA",
        "first_name": "TEREZA",
        "credential": "MA, LMHCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-25",
        "last_updated": "2015-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MC60574012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmonds, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2015; 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.