David Robert Jedrziewski, LMHC, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MT4096 Issued in FL

Practice address

6282 Dupont Station CT E Ste 2
Jacksonville, FL 32217-2515

Phone

(904) 614-4190

NPI assigned

May 13, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Marriage and Family Therapist

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mental Health Specialty Group PAGroup PAC ID 8921466228, 726 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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.

• Casey Center for Community Counseling

  • Marriage & Family Therapist
  • Jacksonville, FL
  • NPI 1275377236

  Mental Health

  Medicare reassignment NPD Authorized official
• Mental Health Specialty Group PA

  dba Rula Health

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  FL

  Medicare reassignment Care Compare group NPD
• Casey Center for Community Counseling

  • Mental Health Counselor
  • Fleming Island, FL
  • NPI 1811513534
  NPD Authorized official
• New Path Psychology Educational and Psychological Services

  dba New Path Psychology

  • Psychologist
  • Jacksonville, FL
  • NPI 1730574286

  Multi-Specialty

  NPD

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

{
    "created_epoch": "1620864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1538733779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6282 DUPONT STATION CT E STE 2",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322172515",
            "telephone_number": "904-614-4190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6282 DUPONT STATION CT E STE 2",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322172515",
            "telephone_number": "904-614-4190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEDRZIEWSKI",
        "first_name": "DAVID",
        "middle_name": "ROBERT",
        "credential": "LMHC, LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-13",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH19172",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MT4096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melchisedek Jean, PA-C
• Naderge Jean, ARNP, MSN, FNP-BC
• Swetha Sundaralingam Jean, PA-C
• Jeanne D Montross Arnp PA
• Abdullah Jebrini, MD
• Jeff Jacqmein MD,PA
• Jefferson Caregiving Services
• Janet Jefferson Hastings
• Jefferson Health Care (Felicia Jefferson)
• Jefferson Pharmacy LLC

• Marriage & Family Therapist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Marriage & Family Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.