D. Fennell Jr, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH15956 Issued in FL

Legal business name

D. FENNELL JR, LLC

Practice address

400 N Ashley Dr Ste 2600
Tampa, FL 33602-4310

Phone

(813) 557-7118

NPI assigned

Aug 14, 2018

Last updated

Aug 14, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Darrell Wayne FennellNPI 1639668692

Title

President

Phone

(813) 557-7118

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Darrell Wayne Fennell Jr., LMHC

  • Mental Health Counselor
  • Tampa, FL
  • NPI 1639668692
  NPD (past) Authorized official

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

{
    "created_epoch": "1534204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534204800000",
    "number": "1396225918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8315 BERKELEY MANOR BLVD",
            "city": "SPRING HILL",
            "state": "FL",
            "postal_code": "34606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N ASHLEY DR STE 2600",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336024310",
            "telephone_number": "813-557-7118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "D. FENNELL JR, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-14",
        "last_updated": "2018-08-14",
        "status": "A",
        "authorized_official_last_name": "FENNELL",
        "authorized_official_first_name": "DARRELL",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-557-7118"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH15956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Tampa, FL
• Providers in Tampa, 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 Aug 14, 2018; 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.