Active NPI
Jessica Suzanne Brown
- Mental Health Counselor
- Fort Pierce, FL
National Provider Identifier
1275189987
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MH22113
- Practice address
- 2011 S 25TH St Ste 108
Fort Pierce, FL 34947-4795 - Phone
- (772) 242-1079
- NPI assigned
- Aug 18, 2019
- Last updated
- Feb 14, 2025
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | FL | ||
| Mental Health Counselor | 101YM0800X | MH22113 | FL | Primary |
Addresses
Primary practice location
2011 S 25TH St Ste 108
Fort Pierce, FL 34947-4795
Mailing address
34 Maria Louisa LN
Greenville, SC 29609-1730
Phone (772) 267-0877
Other names 1
- Jessica Suzanne Drew
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 |
|---|---|---|---|
| MH22113 | FL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1566086400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739491200000",
"number": "1275189987",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34 MARIA LOUISA LN",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296091730",
"telephone_number": "772-267-0877"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2011 S 25TH ST STE 108",
"city": "FORT PIERCE",
"state": "FL",
"postal_code": "349474795",
"telephone_number": "772-242-1079"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "JESSICA",
"middle_name": "SUZANNE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-18",
"last_updated": "2025-02-14",
"certification_date": "2025-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "MH22113",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JESSICA",
"last_name": "DREW",
"middle_name": "SUZANNE",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Fort Pierce, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 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.