Active NPI
Kelly Marie Jenner
- Professional Counselor
- New Providence, NJ
National Provider Identifier
1669634697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 37PC00486500
- Practice address
- 139 South St
Suite 201
New Providence, NJ 07974-1999 - Phone
- (908) 477-6393
- NPI assigned
- Jul 1, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 37PC00486500 | NJ | Primary |
Addresses
Primary practice location
139 South St
Suite 201
New Providence, NJ 07974-1999
Mailing address
139 South St
Suite 201
New Providence, NJ 07974-1999
Phone (908) 477-6393
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37PC00486500 | NJ | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214870400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1390262400000",
"number": "1669634697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "139 SOUTH ST",
"address_2": "SUITE 201",
"city": "NEW PROVIDENCE",
"state": "NJ",
"postal_code": "079741999",
"telephone_number": "908-477-6393"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "139 SOUTH ST",
"address_2": "SUITE 201",
"city": "NEW PROVIDENCE",
"state": "NJ",
"postal_code": "079741999",
"telephone_number": "908-477-6393"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENNER",
"first_name": "KELLY",
"middle_name": "MARIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-07-01",
"last_updated": "2014-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NJ",
"license": "37PC00486500",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Providence, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.