Individual provider Active NPI

Jessica Perrone Stebbins, M.S., LMFT

  • Marriage & Family Therapist
  • Merritt Island, FL
National Provider Identifier
1447500889
Registry record updated Feb 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MT 2696 Issued in FL
Practice address
2460 N Courtenay Pkwy
Ste 114
Merritt Island, FL 32953-4101
Phone
(321) 615-1741
NPI assigned
Sep 13, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MT 2696 FL Primary

Addresses

Primary practice location

2460 N Courtenay Pkwy
Ste 114
Merritt Island, FL 32953-4101

Mailing address

2460 N Courtenay Pkwy
Ste 114
Merritt Island, FL 32953-4101
Phone (321) 615-1741

Medicare participation

Medicare enrollment files
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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
MT 2696FLMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Brevard Family Wellness Center, LLC Marriage & Family Therapist Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1347494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393200000000",
    "number": "1447500889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2460 N COURTENAY PKWY",
            "address_2": "STE 114",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329534101",
            "telephone_number": "321-615-1741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2460 N COURTENAY PKWY",
            "address_2": "STE 114",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329534101",
            "telephone_number": "321-615-1741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEBBINS",
        "first_name": "JESSICA",
        "middle_name": "PERRONE",
        "credential": "M.S., LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-13",
        "last_updated": "2014-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MT 2696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merritt Island, FL

Sources for this page

Verify at the official NPI Registry.