MS. JENNIFER NIKOLE KENDRA MARVIN (NPI# 1215150420) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215150420 |
| Entity Type | Individual |
| Full Name | MS. JENNIFER NIKOLE KENDRA MARVIN |
| Credential | LMHC |
| Practice Address |
2400 S Ridgewood Ave Ste 17 South Daytona FL 32119-3073 |
| Mailing Address |
4726 Florence St Apopka FL 32712-5540 |
| Practice Telephone | 4079296251 |
| Mailing Telephone | 4079296251 |
| Mailing Fax Number | 4077880362 |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2019-10-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | MH5186 | FL | Behavioral Health & Social Service Providers |
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
MH5186 | FL | Behavioral Health & Social Service Providers |
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
MH5186 | FL | Behavioral Health & Social Service Providers |
| N | 101YP2500X |
Counselor Specialization: Professional |
MH5186 | FL | Behavioral Health & Social Service Providers |
| N | 104100000X | Social Worker | MH5186 | FL | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 004240900 | 05 | |
| FL | 076933900 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 315 N Lakemont Ave, Suite B, Winter Park, FL 327923205 | 4078316412 | 4078308413 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477106680 | Jennifer Marvin | Pharmacist | 20 York St, New Haven, CT 06510-3220 | 2019-07-17 |
| 1598237612 | Jennifer Marvin | Counselor | 1113 Healthway Dr, Salisbury, MD 21804-4470 | 2018-12-31 |
| 1932524063 | Jennifer Marvin | Case Manager/Care Coordinator | 140 South Holly Street, Medford, OR 97501 | 2014-02-26 |
| 1295890085 | Jennifer Marvin | Occupational Therapist | 4901 N Shore Dr, North Little Rock, AR 72118-5293 | 2006-12-22 |
| Street Address |
2400 S RIDGEWOOD AVE STE 17 |
| City | SOUTH DAYTONA |
| State | FL |
| Zip Code | 32119-3073 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932594405 | Faith Townsend | Counselor | 2400 S Ridgewood Ave Ste 17, South Daytona, FL 32119 | 2015-04-01 |
| 1538564802 | Chase Therapies | Counselor | 2400 S Ridgewood Ave Ste 17, South Daytona, FL 32119-3073 | 2014-10-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710509476 | Peaceful Healing Solutions, LLC | Social Worker | 1655 Restarrick Ave, South Daytona, FL 32119 | 2020-05-15 |
| 1124570585 | Kunning Li | Acupuncturist | 2135 S Ridgewood Ave, South Daytona, FL 32119 | 2016-11-01 |
| 1720451040 | Tyler M Mckinniss | Chiropractor | 1614 S Ridgewood Ave Ste 200, South Daytona, FL 32119 | 2015-11-09 |
| 1821428954 | Jesse Robert Hodges Jr. | Chiropractor | 1780 S Nova Rd Ste 4, South Daytona, FL 32119 | 2013-11-27 |
| 1831347350 | Pamela Marie Lavigna | Counselor | 1635 S. Ridgewood Ave, Suite 225, South Daytona, FL 32119 | 2008-09-09 |
| 1922214279 | Karen Sue Pulaski | Physical Therapist | 401 Venture Ave. Suite C, South Daytona, FL 32119 | 2007-05-15 |
| 1245369180 | Cathryn C Cucchiaro | Marriage & Family Therapist | 2001 S Ridgewood Ave, South Daytona, FL 32119 | 2007-03-05 |
| 1629136775 | Dennis Andrew Kuack | Dentist | 2644 S Ridgewood Ave, South Daytona, FL 32119 | 2006-12-04 |
| 1639246630 | Robert J Amara | Chiropractor | 2750 S Ridgewood Ave #c, South Daytona, FL 32119 | 2006-11-29 |
| 1306910385 | Filutowski Eye Institute Pa | Clinic/Center | 110 Yorktowne Drive, Daytona Beach, FL 32119 | 2006-11-20 |
| Find all providers in zip 32119 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780155143 | Amanda Victoria Perez | Counselor | 2299 S Ridgewood Ave, South Daytona, FL 32119-3017 | 2018-12-11 |
| 1194095521 | Susan Rita Kicklighter | Counselor | 749 Millbrook Ln, South Daytona, FL 32119-2733 | 2012-01-02 |
| 1710268594 | Janis Carol Sayers | Counselor | 2400 S Ridgewood Ave Ste 32, South Daytona, FL 32119-3073 | 2011-09-07 |
| 1831347350 | Pamela Marie Lavigna | Counselor | 1635 S. Ridgewood Ave, Suite 225, South Daytona, FL 32119 | 2008-09-09 |
| 1952508871 | Angela Rae Ullery | Counselor | 1601 Big Tree Rd Apt 708, South Daytona, FL 32119-8646 | 2007-07-03 |
| 1558970491 | Insightful Therapeutic Solutions LLC | Counselor | 2447 S Ridgewood Ave, South Daytona, FL 32119-3077 | 2020-07-27 |
| 1679112361 | Lindsay Paige Marriott | Counselor | 2400 S Ridgewood Ave, South Daytona, FL 32119-3097 | 2019-12-30 |
| 1518506518 | Jamaruz Thompkins | Counselor | 2400 S Ridgewood Ave Ste 32, South Daytona, FL 32119-3073 | 2019-12-23 |
| 1184270621 | Martine Rose Wallenberg | Counselor | 2400 S Ridgewood Ave, South Daytona, FL 32119-3097 | 2019-08-12 |
| 1083266795 | Terri Lashell Bailey | Counselor | 2400 S Ridgewood Ave Ste 32, South Daytona, FL 32119-3073 | 2019-07-12 |
| Find all providers in SOUTH DAYTONA | ||||
| City | SOUTH DAYTONA |
| Zip Code | 32119 |
Please comment or provide details below to improve the information on MS. JENNIFER NIKOLE KENDRA MARVIN.
| 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.