Individual provider Active NPI

Jennifer Rebecca Stevens, MFT

  • Marriage & Family Therapist
  • Kapa'a, HI
National Provider Identifier
1770799876
Registry record updated Aug 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
126 Issued in HI
Practice address
4566 Ohia St Suite E
Kapaa, HI 96746-1646
Phone
(808) 482-0994
NPI assigned
May 15, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 40710 CA
Marriage & Family Therapist 106H00000X 126 HI Primary

Addresses

Primary practice location

4566 Ohia St Suite E
Kapaa, HI 96746-1646

Mailing address

7211 Aina Pono St
Kapaa, HI 96746-9340
Phone (808) 482-0994

Other practice location 1

4504 Kukui St Ste 202
Kapaa, HI 96746-1701
Phone (808) 482-0994

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
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
I20240305003974 HI Practitioner - Marriage and Family Therapist 7012352602 Practice locations: Kapaa, HI

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4504 Kukui St
Suite 202
Kapaa, HI 96746-1701
Phone (808) 482-0994

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40710CAMDMarriage & Family Therapist
126HIMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630022400000",
    "number": "1770799876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7211 AINA PONO ST",
            "city": "KAPAA",
            "state": "HI",
            "postal_code": "967469340",
            "telephone_number": "808-482-0994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4566 OHIA ST SUITE E",
            "city": "KAPAA",
            "state": "HI",
            "postal_code": "967461646",
            "telephone_number": "808-482-0994"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4504 Kukui St Ste 202",
            "address_purpose": "LOCATION",
            "city": "Kapaa",
            "state": "HI",
            "postal_code": "967461701",
            "country_code": "US",
            "telephone_number": "808-482-0994",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "JENNIFER",
        "middle_name": "REBECCA",
        "name_prefix": "Ms.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "40710",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "HI",
            "license": "126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kapa'a, HI

Sources for this page

Verify at the official NPI Registry.