Individual provider Active NPI

Jacqueline Dee Vitek, LMFT

  • Marriage & Family Therapist
  • Vero Beach, FL
National Provider Identifier
1780933176
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MT 2999 Issued in FL
Practice address
1485 37TH St Ste 112B
Vero Beach, FL 32960-6518
Phone
(772) 300-5885
NPI assigned
Aug 31, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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 MT 2999 FL Primary

Addresses

Primary practice location

1485 37TH St Ste 112B
Vero Beach, FL 32960-6518

Mailing address

1485 37TH St Ste 112B
Vero Beach, FL 32960-6518
Phone (772) 300-5885

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
I20240108000386 FL Practitioner - Marriage and Family Therapist 0446601157 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1485 37TH St
Suite 112B
Vero Beach, FL 32960-6518
Phone (772) 300-5885

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MT 2999FLMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Positive Pineapple Therapy, LLC Marriage & Family Therapist CurrentSince Jan 1, 2024 Accepting new patients

Locations

505 Beachland Blvd
Ste 1
Vero Beach, FL 32963
Phone (518) 866-5972

1485 37th St
Ste 112B
Vero Beach, FL 32960
Phone (772) 300-5885

Organizations & group practices 1

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": "1346371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1780933176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1485 37TH ST STE 112B",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329606518",
            "telephone_number": "772-300-5885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1485 37TH ST STE 112B",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329606518",
            "telephone_number": "772-300-5885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VITEK",
        "first_name": "JACQUELINE",
        "middle_name": "DEE",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-31",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MT 2999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

Verify at the official NPI Registry.