Active NPI
Jennifer Purcell, LMFT
- Marriage & Family Therapist
- Makawao, HI
National Provider Identifier
1184094823
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 460
- Practice address
- 1135 Makawao Ave Ste 102
Makawao, HI 96768-7401 - Phone
- (808) 214-7307
- Fax
- (808) 573-6091
- NPI assigned
- Oct 6, 2015
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1727 | HI | |
| Marriage & Family Therapist | 106H00000X | 460 | HI | Primary |
Addresses
Primary practice location
1135 Makawao Ave Ste 102
Makawao, HI 96768-7401
Mailing address
PO Box 1723
Makawao, HI 96768-1723
Phone (808) 214-7307
Other names 1
- Jennifer Johnson
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in HI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Marriage and Family Therapist
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
500 Ala Moana Blvd
Suite 7400
Honolulu, HI 96813-4902
Phone (617) 823-6490
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1727 | HI | MD | Addiction (Substance Use Disorder) Counselor |
| 460 | HI | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mental Health Specialty Group PA | Current | Accepting new patients |
Locations
500 Ala Moana Blvd
Honolulu, HI 96813
Phone (808) 528-2511
500 Ala Moana Blvd
Ste 7400
Honolulu, HI 96813
Phone (617) 823-6490
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1444089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444089600000",
"number": "1184094823",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1723",
"city": "MAKAWAO",
"state": "HI",
"postal_code": "967681723",
"telephone_number": "808-214-7307",
"fax_number": "808-573-6091"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1135 MAKAWAO AVE STE 102",
"city": "MAKAWAO",
"state": "HI",
"postal_code": "967687401",
"telephone_number": "808-214-7307",
"fax_number": "808-573-6091"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PURCELL",
"first_name": "JENNIFER",
"name_prefix": "Mrs.",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-10-06",
"last_updated": "2015-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "HI",
"license": "1727",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "HI",
"license": "460",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JENNIFER",
"last_name": "JOHNSON",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Makawao, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.