Individual provider Active NPI

Jennifer Evelyn Wassel-Bachnik, LMHC

  • Mental Health Counselor
  • Clearwater, FL
National Provider Identifier
1104625813
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
3593 Issued in FL
Practice address
3641 104TH Ave N
Clearwater, FL 33762-5469
Phone
(727) 804-6692
NPI assigned
Mar 13, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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 3593 FL Primary

Addresses

Primary practice location

3641 104TH Ave N
Clearwater, FL 33762-5469

Mailing address

3641 104TH Ave N
Clearwater, FL 33762-5469
Phone (727) 804-6692

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

State licenses

LicenseStateTypeSpecialty
3593FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1741824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1104625813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3641 104TH AVE N",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337625469",
            "telephone_number": "727-804-6692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3641 104TH AVE N",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337625469",
            "telephone_number": "727-804-6692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASSEL-BACHNIK",
        "first_name": "JENNIFER",
        "middle_name": "EVELYN",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-13",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "3593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2025; 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.