Individual provider Active NPI

Ange-Fennie Jean, LMFT

  • Marriage & Family Therapist
  • Miami Lakes, FL
National Provider Identifier
1356622781
Registry record updated Nov 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MT4454 Issued in FL
Practice address
14645 NW 77TH Ave Ste 101
Miami Lakes, FL 33014-2569
Phone
(833) 769-3524
NPI assigned
Aug 30, 2011
Last updated
Nov 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MT4454 FL Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

14645 NW 77TH Ave Ste 101
Miami Lakes, FL 33014-2569

Mailing address

14645 NW 77TH Ave Ste 101
Miami Lakes, FL 33014-2569
Phone (833) 769-3524

Other practice location 1

3900 NW 79th Ave
Suite 501
Doral, FL 33166-6556
Phone (305) 597-3861

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240103000023 FL Practitioner - Marriage and Family Therapist 4183074198 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Personal Recovery Network LLCGroup PAC ID 5092611384, 612 clinicians

Practice addresses (Care Compare)

14645 NW 77TH Ave
Suite 101
Miami Lakes, FL 33014-2569
Phone (786) 785-9033

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Personal Recovery Network LLC CurrentSince Jan 1, 2024 Accepting new patients
Lifestance Health Marriage & Family Therapist CurrentSince Jan 1, 2024 Accepting new patients
A New Beginning Behavioral Services, Inc Mental Health Past Accepting new patients

Locations

2500 NW 107th Ave
Ste 102
Doral, FL 33172
Phone (786) 605-9400

14645 NW 77th Ave
Ste 101
Miami Lakes, FL 33014
Phone (786) 785-9033

250 Corporate Center Ct
Stockbridge, GA 30281
Phone (770) 954-8685

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1314662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762905600000",
    "number": "1356622781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14645 NW 77TH AVE STE 101",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330142569",
            "telephone_number": "833-769-3524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14645 NW 77TH AVE STE 101",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330142569",
            "telephone_number": "833-769-3524"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3900 NW 79th Ave",
            "address_2": "Suite 501",
            "address_purpose": "LOCATION",
            "city": "Doral",
            "state": "FL",
            "postal_code": "331666556",
            "country_code": "US",
            "telephone_number": "305-597-3861",
            "fax_number": "305-597-3863",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEAN",
        "first_name": "ANGE-FENNIE",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-30",
        "last_updated": "2025-11-12",
        "certification_date": "2025-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MT4454",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Lakes, FL

Sources for this page

Verify at the official NPI Registry.