Individual provider Active NPI

Jennifer Renee Millar, MA, LMFT

  • Professional Counselor
  • Bradenton, FL
National Provider Identifier
1093414104
Registry record updated Feb 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LT4556 Issued in FL
Practice address
6425 39TH Ave W
Bradenton, FL 34209-7626
Phone
(941) 909-4508
NPI assigned
Feb 27, 2023
Last updated
Feb 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LT4556 FL Primary
Psychoanalyst 102L00000X LT4556 FL

Addresses

Primary practice location

6425 39TH Ave W
Bradenton, FL 34209-7626

Mailing address

6425 39TH Ave W
Bradenton, FL 34209-7626
Phone (941) 909-4508

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NJ, NY3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20241009002698 FL Practitioner - Marriage and Family Therapist 0143751511 Reassigns benefits to 2 organizations
I20241210001133 NJ Practitioner - Marriage and Family Therapist 0143751511 Reassigns benefits to 1 organization
I20250106000754 NY Practitioner - Marriage and Family Therapist 0143751511 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
LT4556FLMDPsychoanalyst
002243NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Begin Healing Within, LLC CurrentSince Sep 10, 2023 Accepting new patients
Grow Healthcare Group PA Professional CurrentSince Sep 4, 2024 Accepting new patients
MCCD FL Psychiatry Services PA CurrentSince Dec 2, 2024 Accepting new patients
Grow Healthcare Group of New Jersey PC Professional CurrentSince Nov 6, 2024 Accepting new patients

Locations

1301 Riverplace Blvd
Jacksonville, FL 32207

1301 Riverplace Blvd
Ste 800
Jacksonville, FL 32207
Phone (904) 567-6040

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

221 River St
Ste 9
Hoboken, NJ 07030
Phone (201) 439-8902

109 W 27th St
Rm 5S
New York, NY 10001
Phone (332) 230-4572

165 Broadway
Fl 23
New York, NY 10006
Phone (202) 972-4964

Organizations & group practices 4

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": "1677456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1093414104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6425 39TH AVE W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342097626",
            "telephone_number": "941-909-4508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6425 39TH AVE W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342097626",
            "telephone_number": "941-909-4508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLAR",
        "first_name": "JENNIFER",
        "middle_name": "RENEE",
        "name_prefix": "Ms.",
        "credential": "MA, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-27",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "FL",
            "license": "LT4556",
            "primary": true
        },
        {
            "code": "102L00000X",
            "taxonomy_group": "",
            "desc": "Psychoanalyst",
            "state": "FL",
            "license": "LT4556",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.