Jessica Anne Fennell, MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

M1900121 Issued in OH

Practice address

401 Tuscarawas St W Ste 501
Canton, OH 44702-2045

Phone

(440) 260-8300

NPI assigned

Aug 13, 2018

Last updated

Oct 24, 2019By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Ohioguidestone

  • Family Medicine Physician
  • Lorain, OH
  • NPI 1487452603
  NPD (past)

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

{
    "created_epoch": "1534118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571875200000",
    "number": "1629557327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "434 EASTLAND RD",
            "city": "BEREA",
            "state": "OH",
            "postal_code": "440171217",
            "telephone_number": "440-234-2006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 TUSCARAWAS ST W STE 501",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447022045",
            "telephone_number": "440-260-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENNELL",
        "first_name": "JESSICA",
        "middle_name": "ANNE",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-13",
        "last_updated": "2019-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OH",
            "license": "M1800112-TRNE",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OH",
            "license": "M1900121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jodi Lee Fellers, M.A.
• Andrew Michael Feltman, LSW
• Erin Marie Fenk
• Laura Elizabeth Fenn, CNP
• Cassandra Fennell
• Heather Anne Ferencik
• Alisha M Ferguson, LPN
• Brian Patrick Ferguson, D.C.
• Lois Ferguson, RN
• Marvin G Ferguson, RPH

• Marriage & Family Therapist in Canton, OH
• Providers in Canton, OH by specialty
• Marriage & Family Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2019; 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.