Active NPI
Jennifer Elizabeth Vandertuuk-Perkins, PHD
- Mental Health Counselor
- Fort Myers, FL
National Provider Identifier
1629228275
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 6401007979
- Practice address
- 1840 Maple Ave
Fort Myers, FL 33901-6017 - Phone
- (616) 450-4197
- NPI assigned
- Sep 19, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | PC005978 | PA | |
| Mental Health Counselor | 101YM0800X | 6401007979 | MI | Primary |
Addresses
Primary practice location
1840 Maple Ave
Fort Myers, FL 33901-6017
Mailing address
1840 Maple Ave
Fort Myers, FL 33901-6017
Phone (616) 450-4197
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6401007979 | MI | MD | Mental Health Counselor |
| PC005978 | PA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776038400000",
"number": "1629228275",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1840 MAPLE AVE",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339016017",
"telephone_number": "616-450-4197"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1840 MAPLE AVE",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339016017",
"telephone_number": "616-450-4197"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANDERTUUK-PERKINS",
"first_name": "JENNIFER",
"middle_name": "ELIZABETH",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-09-19",
"last_updated": "2026-04-13",
"certification_date": "2026-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "PA",
"license": "PC005978",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MI",
"license": "6401007979",
"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 Apr 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.