Provider Demographics
NPI:1548893407
Name:JIMENEZ, SHEILA (MS, LPC, ACS)
Entity type:Individual
Prefix:MS
First Name:SHEILA
Middle Name:
Last Name:JIMENEZ
Suffix:
Gender:F
Credentials:MS, LPC, ACS
Other - Prefix:MRS
Other - First Name:SHEILA
Other - Middle Name:
Other - Last Name:REINOSO-JIMENEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, LPC, ACS
Mailing Address - Street 1:233 MOUNT AIRY RD STE 100
Mailing Address - Street 2:
Mailing Address - City:BASKING RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07920-2338
Mailing Address - Country:US
Mailing Address - Phone:908-434-6008
Mailing Address - Fax:
Practice Address - Street 1:233 MOUNT AIRY RD STE 100
Practice Address - Street 2:
Practice Address - City:BASKING RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07920-2338
Practice Address - Country:US
Practice Address - Phone:908-434-6008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-19
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00622100101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1053003608OtherNPI1-MARY SARAH
NJ1578197380OtherNPI1
NJ37PC00622100OtherSTATE OF NEW JERSEY-NEW JERSEY OFFICE OF ATTORNEY GENERAL DIVISION OF CONSUMER A