Individual provider Active NPI

Jackleen M Levy, MS

  • Mental Health Counselor
  • Clermont, FL
National Provider Identifier
1922513290
Registry record updated Dec 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
16593 Issued in FL
Practice address
1050 US Highway 27
Clermont, FL 34714-7520
Phone
(352) 394-0573
NPI assigned
Dec 8, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2017

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 16593 FL Primary

Addresses

Primary practice location

1050 US Highway 27
Clermont, FL 34714-7520

Mailing address

1050 US Highway 27 Ste 9
Clermont, FL 34714-7508

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
I20231130001336 FL Practitioner - Mental Health Counselor 0648628750 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
16593FLMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Health Management Services, Inc Mental Health CurrentSince Jan 1, 2024 Accepting new patients
Behavioral Health Management Services, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Behavioral Health Management Services, Inc. Current Accepting new patients
Winter Haven Hospital Inc CurrentSince Apr 28, 2024 Accepting new patients
Winter Haven Hospital Inc CurrentSince Apr 28, 2024 Accepting new patients
Neumind Wellness Group LLC Past Accepting new patients

Locations

2995 Drew St
Fl 2
Clearwater, FL 33759
Phone (727) 315-7234

1106 Druid Rd S
Clearwater, FL 33756
Phone (727) 584-6266

2727 W Mlk Blvd
Ste 640
Tampa, FL 33607
Phone (813) 842-7582

Interoperability endpoints

  • Direct secure messaging: jackleen.levylmhc@direct.mybaycare.org

Organizations & group practices 6

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": "1512691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512691200000",
    "number": "1922513290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 US HIGHWAY 27 STE 9",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347147508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 US HIGHWAY 27",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347147520",
            "telephone_number": "352-394-0573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVY",
        "first_name": "JACKLEEN",
        "middle_name": "M",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-08",
        "last_updated": "2017-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "16593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

Verify at the official NPI Registry.