Individual provider Active NPI

Jennifer Pechenik, LCSW, PSYD

  • Psychologist
  • Aventura, FL
National Provider Identifier
1619090503
Registry record updated Feb 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY8436 Issued in FL
Practice address
18851 NE 29TH Ave Ste 700
Aventura, FL 33180-2845
Phone
(954) 294-5867
NPI assigned
Apr 7, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW4682 FL
Psychologist 103T00000X PY8436 FL Primary

Addresses

Primary practice location

18851 NE 29TH Ave Ste 700
Aventura, FL 33180-2845

Mailing address

20533 Biscayne Blvd Ste 4-135
Aventura, FL 33180-1529
Phone (954) 294-5867

Other practice location 1

20533 Biscayne Blvd Ste 4-135
Aventura, FL 33180-1529
Phone (954) 294-5867

Other practice location 2

3005 Oaktree Ln
Hollywood, FL 33021-2667
Phone (195) 429-4586

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20200720000623 FL Practitioner - Clinical Psychologist 3678879061 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

20533 Biscayne Blvd
Suite 4 135
Aventura, FL 33180-1529
Phone (954) 294-5867

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW4682FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Today's World Consultants, LLC CurrentSince Oct 1, 2015 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1175904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643760000000",
    "number": "1619090503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20533 BISCAYNE BLVD STE 4-135",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331801529",
            "telephone_number": "954-294-5867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18851 NE 29TH AVE STE 700",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331802845",
            "telephone_number": "954-294-5867"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20533 Biscayne Blvd Ste 4-135",
            "address_purpose": "LOCATION",
            "city": "Aventura",
            "state": "FL",
            "postal_code": "331801529",
            "country_code": "US",
            "telephone_number": "954-294-5867",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3005 Oaktree Ln",
            "address_purpose": "LOCATION",
            "city": "Hollywood",
            "state": "FL",
            "postal_code": "330212667",
            "country_code": "US",
            "telephone_number": "195-429-4586",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PECHENIK",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "LCSW, PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-07",
        "last_updated": "2022-02-02",
        "certification_date": "2022-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW4682",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY8436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aventura, FL

Sources for this page

Verify at the official NPI Registry.