Individual provider Active NPI

Jennifer Renee Feldman, LMHC

  • Mental Health Counselor
  • St Petersburg, FL
National Provider Identifier
1639292592
Registry record updated Feb 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH11517 Issued in FL
Practice address
124 18TH Ave S
St Petersburg, FL 33705-2735
Phone
(727) 723-5634
NPI assigned
Apr 7, 2007
Last updated
Feb 1, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2013

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 MH11517 FL Primary

Addresses

Primary practice location

124 18TH Ave S
St Petersburg, FL 33705-2735

Mailing address

123 18TH Ave S
St Petersburg, FL 33705-2734
Phone (727) 723-5634

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
I20240319004174 FL Practitioner - Mental Health Counselor 7810334307 Practice locations: St Petersburg, FL

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2009
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

124 18TH Ave S
St Petersburg, FL 33705-2735
Phone (727) 220-3805

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH11517FLMDMental Health Counselor

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": "1359676800000",
    "number": "1639292592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 18TH AVE S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337052734",
            "telephone_number": "727-723-5634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 18TH AVE S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337052735",
            "telephone_number": "727-723-5634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELDMAN",
        "first_name": "JENNIFER",
        "middle_name": "RENEE",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-07",
        "last_updated": "2013-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH11517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.