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General NPI Number Information
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NPI Number | 1750928008
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Entity Type | Individual
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Provider Name | ENRIQUE JIMENEZ M.ED, LPCC
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Gender | Male
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Dates
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Enumeration Date | 12/05/2019
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Last Update Date | 04/18/2024
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Provider Practice Location Address
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Address Line | 4041 N HIGH ST STE 102
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City | COLUMBUS
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State | OH
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Zip | 43214-3248
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Country | US
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Telephone | 614-931-0228
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Fax |
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Provider Business Mailing Address
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Address Line | 118 E WHEELING ST
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City | LANCASTER
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State | OH
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Zip | 43130-3705
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | C.2103488
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | E.2303684
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License Number State | OH
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