Individual provider Active NPI

Jennifer Kristen Ackerman, MSED

  • Mental Health Counselor
  • Fort Myers, FL
National Provider Identifier
1598016891
Registry record updated Sep 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
IMH 3521 Issued in FL
Practice address
10140 Deer Run Farms Rd
Fort Myers, FL 33966-1045
Phone
(239) 275-4242
NPI assigned
Sep 26, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X IMH 3521 FL Primary

Addresses

Primary practice location

10140 Deer Run Farms Rd
Fort Myers, FL 33966-1045

Mailing address

10140 Deer Run Farms Rd
Fort Myers, FL 33966-1045
Phone (239) 275-4242

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
IMH 3521FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1348617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348617600000",
    "number": "1598016891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10140 DEER RUN FARMS RD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339661045",
            "telephone_number": "239-275-4242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10140 DEER RUN FARMS RD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339661045",
            "telephone_number": "239-275-4242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACKERMAN",
        "first_name": "JENNIFER",
        "middle_name": "KRISTEN",
        "name_prefix": "Mrs.",
        "credential": "MSED",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-26",
        "last_updated": "2012-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH 3521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2012; 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.