Active NPI
Destini Jazzmyn Kohnen, LMHC
- Mental Health Counselor
- Bridgewater, MA
National Provider Identifier
1154919116
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 12117-MH-CC
- Practice address
- 1029 Pleasant St Ste 101
Bridgewater, MA 02324-2473 - Phone
- (508) 697-1070
- NPI assigned
- Jan 5, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 12117-MH-CC | MA | Primary |
Addresses
Primary practice location
1029 Pleasant St Ste 101
Bridgewater, MA 02324-2473
Mailing address
1029 Pleasant St Ste 101
Bridgewater, MA 02324-2473
Phone (508) 697-1070
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
| License | State | Type | Specialty |
|---|---|---|---|
| 12117-MH-CC | MA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1609804800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609804800000",
"number": "1154919116",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1029 PLEASANT ST STE 101",
"city": "BRIDGEWATER",
"state": "MA",
"postal_code": "023242473",
"telephone_number": "508-697-1070"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1029 PLEASANT ST STE 101",
"city": "BRIDGEWATER",
"state": "MA",
"postal_code": "023242473",
"telephone_number": "508-697-1070"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOHNEN",
"first_name": "DESTINI",
"middle_name": "JAZZMYN",
"credential": "LMHC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-01-05",
"last_updated": "2021-01-05",
"certification_date": "2021-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "12117-MH-CC",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bridgewater, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.