Jenelle Coolidge, MS

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH21266 Issued in FL

Practice address

6644 Vineland Rd
Suite 270
Orlando, FL 32819

Phone

(253) 310-3910

NPI assigned

Jun 25, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Jenelle Patricia Gonzalez, Banaszak Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cool Skies Counseling LLC

  • Community/Behavioral Health Agency
  • Orlando, FL
  • NPI 1720829922
  NPD Authorized official

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

{
    "created_epoch": "1403654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663545600000",
    "number": "1558776880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6645 VINELAND RD STE 270",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328197840",
            "telephone_number": "253-310-3910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6644 VINELAND RD",
            "address_2": "SUITE 270",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32819",
            "telephone_number": "253-310-3910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOLIDGE",
        "first_name": "JENELLE",
        "credential": "MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-25",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH19534",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH21266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENELLE",
            "last_name": "GONZALEZ, BANASZAK",
            "middle_name": "PATRICIA",
            "credential": "MS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Marisa P. Cooke, P.A.
• Samantha Cooke
• Michael Cooksey, PA-C
• Cool Skies Counseling LLC
• Kristie Cooley, LMHC
• Melissa Coombs, RN
• Teresa Nyingi Coon, RN
• Alicia J. Coonce, DO
• John R Cooney, LCSW
• Samantha Cooney

• Mental Health Counselor in Orlando, FL
• Providers in Orlando, 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 Sep 19, 2022; 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.