Marvin, Jennifer Nikole Kendra
Marvin, Jennifer Nikole Kendra is an sole proprietor health care provider with primary practice located at 2400 S Ridgewood Ave Ste 17 , South Daytona FL 32119-3073. She recently has 5 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Marvin, Jennifer Nikole Kendra can be contacted via phone (407) 929-6251.Contact Information
Primary practice address
2400 S Ridgewood Ave Ste 17
South Daytona FL 32119-3073
Phone: (407) 929-6251
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Counselor | 101Y00000X | MH5186 | Florida |
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | MH5186 | Florida |
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | MH5186 | Florida |
| Behavioral Health & Social Service Providers / Social Worker | 104100000X | MH5186 | Florida |
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | MH5186 | Florida |
Profile Details
| NPI number | 1215150420 |
|---|---|
| LBN Legal business name | Marvin, Jennifer Nikole Kendra |
| Credentials | LMHC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 10th, 2007 |
| Last updated | Oct 8th, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215150420 | NPPES |
| Florida | MEDICAID | 004240900 | |
| Florida | MEDICAID | 076933900 |
Popular Providers
-
Lavigna, Pamela Marie
1635 S. Ridgewood Ave, Suite 225 , South Daytona FL 32119 -
Sosa Rodriguez, Laura M
2400 S Ridgewood Ave Ste 32 , South Daytona FL 32119-3073 -
Pagan, Melissa
2400 S Ridgewood Ave Ste 32 , South Daytona FL 32119-3073 -
Kicklighter, Susan Rita
749 Millbrook Ln , South Daytona FL 32119-2733 -
Sayers, Janis Carol
2400 S Ridgewood Ave Ste 32 , South Daytona FL 32119-3073 -
Hardy, Donna Marie
2400 S Ridgewood Ave Ste 32 , South Daytona FL 32119-3073 -
Macginnis, Neil David
2400 S Ridgewood Ave Suite 32, South Daytona FL 32119-3097 -
Wallenberg, Martine Rose
2400 S Ridgewood Ave , South Daytona FL 32119-3097