Individual provider Active NPI

Jennifer M Jenkins

  • Mental Health Counselor
  • Columbia, MD
National Provider Identifier
1720749880
Registry record updated Dec 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
10632 Little Patuxent Pkwy Ste 309
Columbia, MD 21044-6294
Phone
(443) 313-6350
NPI assigned
Dec 31, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 31, 2021

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

10632 Little Patuxent Pkwy Ste 309
Columbia, MD 21044-6294

Mailing address

10632 Little Patuxent Pkwy Ste 309
Columbia, MD 21044-6294

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20260423001575 VA Practitioner - Mental Health Counselor 9537636907 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Starting Point of Virginia PCGroup PAC ID 9931535820, 26 clinicians

Practice addresses (Care Compare)

300 Valley St NE
Abingdon, VA 24210-2912
Phone (800) 805-6989

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Live Free Therapy LLC Mental Health CurrentSince Jan 2, 2022 Accepting new patients

Locations

10632 Little Patuxent Pkwy
Ste 309
Columbia, MD 21044
Phone (443) 313-6350

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1640908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640908800000",
    "number": "1720749880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10632 LITTLE PATUXENT PKWY STE 309",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210446294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10632 LITTLE PATUXENT PKWY STE 309",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210446294",
            "telephone_number": "443-313-6350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-31",
        "last_updated": "2021-12-31",
        "certification_date": "2021-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

Verify at the official NPI Registry.