Individual provider Active NPI

Tiffani Jimenez

  • Marriage & Family Therapist
  • Brooklyn, NY
National Provider Identifier
1972016939
Registry record updated Jul 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
002699 Issued in NY
Practice address
102 Pilling St
Brooklyn, NY 11207-1610
Phone
(718) 602-1000
NPI assigned
Nov 13, 2017
Last updated
Jul 27, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MI2851 NV
Marriage & Family Therapist 106H00000X 002699 NY Primary

Addresses

Primary practice location

102 Pilling St
Brooklyn, NY 11207-1610

Mailing address

110 Post Ave Apt 610
New York, NY 10034-3413
Phone (646) 761-4603

Other identifiers 1

IdentifierTypeStateIssuer
2105585335MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20260223002871 NY Practitioner - Marriage and Family Therapist 8123509601 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Group practices
New York Psychotherapy and Counseling CenterGroup PAC ID 4880600147, 113 clinicians

Practice addresses (Care Compare)

102 Pilling St
Brooklyn, NY 11207-1610
Phone (718) 602-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MI2851NVMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
New York Psychotherapy and Counseling Center CurrentSince Jan 26, 2026 Accepting new patients
Coordinated Behavioral Care Ipa Inc PastSince Oct 24, 2021 Accepting new patients

Locations

102 Pilling St
Brooklyn, NY 11207
Phone (718) 602-1000

2857 Linden Blvd
Brooklyn, NY 11208
Phone (718) 235-3100

17620 148th Ave
Jamaica, NY 11434
Phone (718) 553-1100

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": "1510531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1972016939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 POST AVE APT 610",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100343413",
            "telephone_number": "646-761-4603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 PILLING ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112071610",
            "telephone_number": "718-602-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "TIFFANI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-13",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NV",
            "license": "MI2851",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NY",
            "license": "002699",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2105585335",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.