Individual provider Active NPI

Jacquelyn Delores Fresenius, LMHC

  • Mental Health Counselor
  • Naples, FL
National Provider Identifier
1386655355
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH7913 Issued in FL
Practice address
501 Goodlette Rd N
#B206
Naples, FL 34102-5473
Phone
(239) 659-1313
Fax
(239) 659-1313
NPI assigned
Aug 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH7913 FL Primary

Addresses

Primary practice location

501 Goodlette Rd N
#B206
Naples, FL 34102-5473

Mailing address

501 Goodlette Rd N
#B206
Naples, FL 34102-5473
Phone (239) 659-1313

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

LicenseStateTypeSpecialty
MH7913FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386655355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 GOODLETTE RD N",
            "address_2": "#B206",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341025473",
            "telephone_number": "239-659-1313",
            "fax_number": "239-659-1313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 GOODLETTE RD N",
            "address_2": "#B206",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341025473",
            "telephone_number": "239-659-1313",
            "fax_number": "239-659-1313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRESENIUS",
        "first_name": "JACQUELYN",
        "middle_name": "DELORES",
        "name_prefix": "Ms.",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH7913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.