Jenny Lee Sandell, LMHC, NCC, CCMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH 10736 Issued in FL

Practice address

115 College Dr
Orange Park, FL 32065-9035

Phone

(904) 602-9802

Fax

(904) 621-5113

NPI assigned

Apr 27, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 1, 2024 through Apr 1, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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 and National Provider Directory roles.

• Full Circle Counseling Services, LLC

  • Counselor
  • Orange Park, FL
  • NPI 1902253495
  NPD Authorized official

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

{
    "created_epoch": "1303862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671494400000",
    "number": "1386935245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 65190",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320650004",
            "telephone_number": "904-602-9802",
            "fax_number": "904-621-5113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 COLLEGE DR",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320659035",
            "telephone_number": "904-602-9802",
            "fax_number": "904-621-5113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDELL",
        "first_name": "JENNY",
        "middle_name": "LEE",
        "credential": "LMHC, NCC, CCMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-27",
        "last_updated": "2022-12-20",
        "certification_date": "2022-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH 10736",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10736",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@fccounseling.org",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "115 College Dr",
            "city": "Orange Park",
            "state": "FL",
            "country_code": "US",
            "postal_code": "320659035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jacqueline Sampson
• Samson Villa of Orange Park
• Jacquatta M Samuels
• John S Sanad, RPH.
• Justine Sandberg, BCBA
• Kalinah Marianna Sanders
• Kandise Nicole Sanders
• Kimberly Sanders, MD
• Sunny Sundeep Sandhu, M.D.
• Sandy Rosenberg DMD PL

• Mental Health Counselor in Orange Park, FL
• Providers in Orange Park, 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 Dec 20, 2022; 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.