Individual provider Active NPI

Jennifer Simic, LPC

  • Professional Counselor
  • Dayton, OH
National Provider Identifier
1457114688
Registry record updated Jul 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
C.2506748 Issued in OH
Practice address
10861 Yankee St
Dayton, OH 45458-3574
Phone
(888) 830-0347
NPI assigned
Jan 31, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X C.2304962-TRNE OH
Professional Counselor 101YP2500X C.2506748 OH Primary

Addresses

Primary practice location

10861 Yankee St
Dayton, OH 45458-3574

Mailing address

410 Layne Dr
Xenia, OH 45385-2538
Phone (937) 751-4273

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
C.2304962-TRNEOHMDCounselor
C.2506748OHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mindfully Psychiatry LLC Past Accepting new patients
Mindfully, LLC Counselor PastSince Apr 3, 2024 Accepting new patients
Mindfully, LLC Counselor Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1706659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753056000000",
    "number": "1457114688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 LAYNE DR",
            "city": "XENIA",
            "state": "OH",
            "postal_code": "453852538",
            "telephone_number": "937-751-4273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10861 YANKEE ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454583574",
            "telephone_number": "888-830-0347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMIC",
        "first_name": "JENNIFER",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-31",
        "last_updated": "2025-07-21",
        "certification_date": "2025-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OH",
            "license": "C.2304962-TRNE",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "C.2506748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2025; 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.