Jenevieve Lynn Wardell, LPC-S

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

2757 Issued in MS

Practice address

2375 Memphis St
Hernando, MS 38632-1756

Phone

(662) 506-3836

Fax

(662) 200-5976

NPI assigned

May 17, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Mar 22, 2024 through Mar 22, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Friends of Children and Families

  • Foster Care Agency
  • Orlando, FL
  • NPI 1558524553
  NPD (past)

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1225245483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "657 DOE CREEK TRL N",
            "city": "HERNANDO",
            "state": "MS",
            "postal_code": "386325018",
            "telephone_number": "704-231-4215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2375 MEMPHIS ST",
            "city": "HERNANDO",
            "state": "MS",
            "postal_code": "386321756",
            "telephone_number": "662-506-3836",
            "fax_number": "662-200-5976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARDELL",
        "first_name": "JENEVIEVE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "LPC-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "12683",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MS",
            "license": "2757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Manley Wadsworth, M.D.
• Wal-Mart Stores East LP (Walmart Pharmacy 10-5419)
• Wal-Mart Stores East, LP (Vision Center 30-5419)
• Walgreen Co (Walgreens # 10706)
• Kristen Nicole Walls, OT
• Malinda Renee Watson, SLP
• Weaver Clinic, LLC
• Callissa L. Wells
• Sherika Lashea Wheeler, PHARMD
• Hannah Elizabeth White, LCSW

• Mental Health Counselor in Hernando, MS
• Providers in Hernando, MS by specialty
• Mental Health Counselor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.