Individual provider Active NPI

Jennifer Dobritch

  • Mental Health Counselor
  • Palm Coast, FL
National Provider Identifier
1689213308
Registry record updated Jun 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
160 Cypress Point Pkwy
Palm Coast, FL 32164-8433
Phone
(614) 702-6623
NPI assigned
Dec 27, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2023

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 Primary

Addresses

Primary practice location

160 Cypress Point Pkwy
Palm Coast, FL 32164-8433

Mailing address

1268 Paradise Pond Rd
Saint Augustine, FL 32092-0791
Phone (614) 702-6623

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

NPI Registry JSON

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

{
    "created_epoch": "1577404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1689213308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1268 PARADISE POND RD",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320920791",
            "telephone_number": "614-702-6623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 CYPRESS POINT PKWY",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321648433",
            "telephone_number": "614-702-6623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOBRITCH",
        "first_name": "JENNIFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-27",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Coast, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2023; 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.