Jennifer Nikole Kendra Marvin, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH5186 Issued in FL

Practice address

2400 S Ridgewood Ave Ste 17
South Daytona, FL 32119-3073

Phone

(407) 929-6251

NPI assigned

Apr 10, 2007

Last updated

Oct 8, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

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 1

Specialty

Mental Health Counselor

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Thriveworks Clinical - Florida IncGroup PAC ID 5496173577, 85 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Thriveworks Clinical - Florida Inc

  • Mental Health Counselor
  • Fort Lauderdale, FL
  • NPI 1396360996
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570492800000",
    "number": "1215150420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4726 FLORENCE ST",
            "city": "APOPKA",
            "state": "FL",
            "postal_code": "327125540",
            "telephone_number": "407-929-6251",
            "fax_number": "407-788-0362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 S RIDGEWOOD AVE STE 17",
            "city": "SOUTH DAYTONA",
            "state": "FL",
            "postal_code": "321193073",
            "telephone_number": "407-929-6251"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "315 N Lakemont Ave",
            "address_2": "Suite B",
            "address_purpose": "LOCATION",
            "city": "Winter Park",
            "state": "FL",
            "postal_code": "327923205",
            "country_code": "US",
            "telephone_number": "407-831-6412",
            "fax_number": "407-830-8413",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARVIN",
        "first_name": "JENNIFER",
        "middle_name": "NIKOLE KENDRA",
        "name_prefix": "Ms.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-10",
        "last_updated": "2019-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "FL",
            "license": "MH5186",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "MH5186",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH5186",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "FL",
            "license": "MH5186",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "FL",
            "license": "MH5186",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004240900",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "076933900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathleen Ann Manning, PTA
• Anne Marconi
• Amber Rose Markowitz, DC
• Lindsay Paige Marriott
• Steven D Marteeny, P.T.A.
• Margaret McCartney
• Cassandra Jane (Robertson) McCathran
• Sharon Bowers McCrary, D.M.D.
• Lorien McDavid
• Abbie McDonald

• Mental Health Counselor in South Daytona, FL
• Providers in South Daytona, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2019; 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.

Verify at the official NPI Registry.