MRS. JENNIFER MAVRICK INGRAM (NPI# 1114125978) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114125978 |
| Entity Type | Individual |
| Full Name | MRS. JENNIFER MAVRICK INGRAM |
| Other Name | JENNIFER MAVRICK |
| Credential | LMHC, CAP |
| Practice Address |
1301 Seminole Blvd Suite 103 Largo FL 33770-8173 |
| Practice Telephone | 7272135379 |
| Practice Fax Number | 2722135370 |
| Mailing Telephone | 7272135379 |
| Mailing Fax Number | 7272135370 |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2011-07-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
2868 | FL | Behavioral Health & Social Service Providers |
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
MH8176 | FL | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | CAQH ID NUMBER | 11691411 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326390535 | Jennifer Leigh Ingram | Occupational Therapy Assistant | 120 Lakes At Litchfield Dr, Pawleys Island, SC 29585-9001 | 2012-10-11 |
| 1013242957 | Jennifer Lynn Ingram | Physical Medicine & Rehabilitation | 6802 Lee Hwy, Chattanooga, TN 37421-2444 | 2009-10-09 |
| 1215183983 | Jennifer Ingram | Audiologist | 833 Saint Vincents Dr, Pob #3 - Suite 402, Birmingham, AL 35205-1606 | 2008-08-14 |
| 1861660284 | Jennifer Ingram | Speech-Language Pathologist | 2250 Hickory Rd, Plymouth Meeting, PA 19462-1047 | 2008-02-19 |
| 1073572921 | Jennifer Ingram | Counselor | 1001 Hadley Rd, Mooresville, IN 46158-1794 | 2006-03-20 |
| Street Address |
1301 SEMINOLE BLVD SUITE 103 |
| City | LARGO |
| State | FL |
| Zip Code | 33770-8173 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336198258 | Terry Lee Capes | Counselor | 1301 Seminole Blvd, Suite 166, Largo, FL 33770-8173 | 2006-05-08 |
| 1326428913 | Healing Stone Therapy Services, LLC | Counselor | 1301 Seminole Blvd, Suite 103 Bldg A, Largo, FL 33760 | 2015-06-09 |
| 1750782231 | Gary Lee Wood | Counselor | 1301 Seminole Blvd, Building A, Suite 103, Largo, FL 33770-8173 | 2014-09-15 |
| 1841632056 | Kristen Mae Lenz | Counselor | 1301 Seminole Blvd, Suite 103, Largo, FL 33770-8173 | 2013-07-29 |
| 1841581105 | Diane Elizabeth Lawrence | Counselor | 1301 Seminole Blvd, Suite H169, Largo, FL 33770-8173 | 2011-04-21 |
| 1083934350 | Alternatives In Behavioral Health, Inc. | Community/Behavioral Health | 1301 Seminole Blvd, Suite 169, Largo, FL 33770-8173 | 2010-06-09 |
| 1184943359 | Jennifer R. Young | Counselor | 1301 Seminole Blvd, Suite 169, Largo, FL 33770-8173 | 2010-05-26 |
| 1184859035 | Richard D Morris, LLC | Counselor | 1301 Seminole Blvd, Suite 103, Largo, FL 33770-8173 | 2009-05-21 |
| 1144473257 | Coastal Behavioral Health Services, LLC | Community/Behavioral Health | 1301 Seminole Blvd, Suite 168, Largo, FL 33770-8173 | 2008-11-03 |
| 1720282916 | Richard D Morris | Counselor | 1301 Seminole Blvd, Suite 103, Largo, FL 33770-8173 | 2007-06-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467005041 | Chelsey Lyn Shepos | Optometrist | 1030 West Bay Dr, Suite 200, Largo, FL 33770 | 2019-07-22 |
| 1407353626 | Michael E Ibrahim | Pharmacist | 1290 West Bay Drive, Largo, FL 33770 | 2018-04-13 |
| 1518413384 | Payton Kuhlenbeck | Anesthesiology | 210 14th Street Sw, Largo, FL 33770 | 2016-08-31 |
| 1639536865 | Ryan Boice | Physical Therapy Assistant | 118 West Bay Drive, Suite 111, Largo, FL 33770 | 2016-01-19 |
| 1508238858 | Alignment Healthcare Florida LLC | Clinic/Center | 1301 2nd Ave., Sw, Largo, FL 33770 | 2015-10-27 |
| 1891161808 | Jessica Nicole Mcglone | Nurse Practitioner | 601 Rosery Rd Ne Apt 1502, Largo, FL 33770 | 2015-08-12 |
| 1033598602 | Demetria Anderson | Counselor | 1301 Seminole Blvd Ste 103, Largo, FL 33770 | 2015-05-28 |
| 1962881821 | Building Blocks Therapy, Pllc | Community/Behavioral Health | 1301 Seminole Blvd Building A Suite 103, Largo, FL 33770 | 2015-05-26 |
| 1457765968 | Summer Moon | Dermatology | 115 Highland Ave N, Largo, FL 33770 | 2014-06-12 |
| 1578982393 | Lauren Elizabeth Grandpre | Emergency Medicine | 201 14th St. Sw, Largo Medical Center Emergency Department, Largo, FL 33770 | 2014-04-09 |
| Find all providers in zip 33770 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629681572 | Daine Barlow | Counselor | 3660 E Bay Dr Apt 1316, Largo, FL 33771-1942 | 2020-08-28 |
| 1346866720 | Jordan Stephen Wyns | Counselor | 11220 Oakhurst Rd, Largo, FL 33774-4447 | 2020-06-22 |
| 1922641059 | Jaclyn Settje Settje | Counselor | 1000 10th St Sw, Largo, FL 33770-4433 | 2019-10-22 |
| 1043851850 | Taquera M Riou | Counselor | 13500 Rodgers Ave Apt 308, Largo, FL 33771-4953 | 2019-10-02 |
| 1134774243 | Vaylah B Clinton | Counselor | 9500 Medical Center Dr Ste 106, Largo, MD 20774-3711 | 2019-08-06 |
| 1083273122 | Abbie Rolf | Counselor | 1000 Belcher Rd S Ste 3, Largo, FL 33771-3307 | 2019-06-12 |
| 1457813743 | Jessica Pitt Lombardo | Counselor | 801 W Bay Dr Ste 340, Largo, FL 33770-3220 | 2019-04-04 |
| 1346711363 | Transitions Counseling and Mentoring Services Inc. | Counselor | 9500 Medical Center Dr Ste 432, Largo, MD 20774-3716 | 2018-12-17 |
| 1710455787 | Empowerment Therapeutic Counseling,llc | Counselor | 1401 Mercantile Ln Ste 200l, Largo, MD 20774-4311 | 2018-11-08 |
| 1700379112 | Richard A Richert | Counselor | Alternatives In Behavioral Health, 1301 Seminole Blvd, Ste 169, Largo, FL 34698 | 2018-06-11 |
| Find all providers in LARGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.