Individual provider Active NPI

Jenny Leverman

  • Mental Health Counselor
  • Chula Vista, CA
National Provider Identifier
1639807399
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
129871 Issued in CA
Practice address
1663 Falling Star Dr
Chula Vista, CA 91915-1812
Phone
(619) 244-1687
NPI assigned
Aug 10, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 129871 CA Primary

Addresses

Primary practice location

1663 Falling Star Dr
Chula Vista, CA 91915-1812

Mailing address

1663 Falling Star Dr
Chula Vista, CA 91915-1812
Phone (619) 244-1687

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Previously, effective Aug 26, 2024 through Aug 26, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
129871CAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1660089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1639807399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1663 FALLING STAR DR",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919151812",
            "telephone_number": "619-244-1687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1663 FALLING STAR DR",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919151812",
            "telephone_number": "619-244-1687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVERMAN",
        "first_name": "JENNY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-10",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "129871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

Verify at the official NPI Registry.