Individual provider Active NPI

Jeannie Marcelin

  • Marriage & Family Therapist
  • Sunrise, FL
National Provider Identifier
1780062331
Registry record updated Dec 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MT4324 Issued in FL
Practice address
9598 NW 53Rd St
Sunrise, FL 33351-7755
Phone
(754) 303-7681
NPI assigned
May 15, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MT4324 FL Primary

Addresses

Primary practice location

9598 NW 53Rd St
Sunrise, FL 33351-7755

Mailing address

9598 NW 53Rd St
Sunrise, FL 33351-7755
Phone (754) 303-7681

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
I20231206000070 FL Practitioner - Marriage and Family Therapist 4284083023 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thriveworks Clinical - Florida IncGroup PAC ID 5496173577, 85 clinicians

Practice addresses (Care Compare)

10100 W Sample Rd
Suite 205
Coral Springs, FL 33065-3975
Phone (855) 284-7483

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Marriage & Family Therapist Current Accepting new patients
Thriveworks Clinical - Florida Inc CurrentSince Jan 1, 2024 Accepting new patients

Locations

10100 W Sample Rd
Ste 205
Coral Springs, FL 33065
Phone (561) 771-5838

2425 E Commercial Blvd
Ste 405
Fort Lauderdale, FL 33308
Phone (754) 400-5514

4115 W Spruce St
Ste 205
Tampa, FL 33607
Phone (813) 413-4663

1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263

Interoperability endpoints

  • Direct secure messaging: jeanniemarcelin@tdh.allscriptsdirect.net

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": "1431648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1780062331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9598 NW 53RD ST",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333517755",
            "telephone_number": "754-303-7681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9598 NW 53RD ST",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333517755",
            "telephone_number": "754-303-7681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCELIN",
        "first_name": "JEANNIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-15",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MT4324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunrise, FL

Sources for this page

Verify at the official NPI Registry.