Individual provider Active NPI

Jennifer Cooper, RMHCI

  • Mental Health Counselor
  • Leesburg, FL
National Provider Identifier
1699496695
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH25008 Issued in FL
Practice address
8136 Centralia CT Ste 101
Leesburg, FL 34788-3757
Phone
(352) 391-4510
NPI assigned
Sep 7, 2022
Last updated
Feb 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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 MH25008 FL Primary

Addresses

Primary practice location

8136 Centralia CT Ste 101
Leesburg, FL 34788-3757

Mailing address

4027 Elm St
Lady Lake, FL 32159-3404
Phone (352) 391-4510

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
I20251109000061 FL Practitioner - Mental Health Counselor 1355830183 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

500 Westover Dr
Sanford, NC 27330-8941

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH25008FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Specialty Group PA Mental Health CurrentSince Oct 9, 2025 Accepting new patients
Grow Healthcare Group PA Mental Health CurrentSince Sep 30, 2025 Accepting new patients

Locations

2328 10th Ave N
Ste 201
Lake Worth, FL 33461
Phone (561) 236-7622

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1662508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1699496695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4027 ELM ST",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321593404",
            "telephone_number": "352-391-4510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8136 CENTRALIA CT STE 101",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347883757",
            "telephone_number": "352-391-4510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "JENNIFER",
        "credential": "RMHCI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-07",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH25008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, FL

Sources for this page

Verify at the official NPI Registry.