ANGE-FENNIE JEAN (LMFT) – Marriage & Family Therapist, NPI 1356622781

ANGE-FENNIE JEAN (LMFT) is a healthcare provider. based in North lauderdale, Florida. specializing in MARRIAGE AND FAMILY THERAPIST. They hold the professional credentials LMFT. They hold a License No. MT4454 (FL). The NPI Number for ANGE-FENNIE JEAN (LMFT) is 1356622781

Main info

Female
9 Years Of Experience
Accepts Medicare Assignment
Name
ANGE-FENNIE JEAN (LMFT)
NPI
1356622781
Phone
(786) 447-2139
Address
1454 AVON LN APT 21
Enumeration Date
30 August 2011
Last Update Date
12 November 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7867859033
Graduation Year
2017 (9 years ago)
PAC ID
4183074198
Group Practice PAC ID
5092611384
Professional Enrollment ID
I20240103000023
Address ID
FL330142569MI14645AVEX401
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience57
Completeness85
Years active:14State licenses:1Digital endpointsOther names

330 MARRIAGE AND FAMILY THERAPIST in FL

Provider Addresses for ANGE-FENNIE JEAN (LMFT)

  • 1454 AVON LN APT 21

    NORTH LAUDERDALE, FL 330685780

    Phone: (786) 447-2139

    Type: Mailing

  • 14645 NW 77TH AVE STE 101

    MIAMI LAKES, FL 330142569

    Phone: (833) 769-3524

    Type: Mailing

  • 3900 NW 79th Ave

    Suite 501

    Doral, FL 331666556

    Phone: (305) 597-3861

    Fax: (305) 597-3863

    Type: Location

  • 3900 NW 79TH AVE

    SUITE 501

    DORAL, FL 331666556

    Phone: (305) 597-3861

    Fax: (305) 597-3863

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-01-03

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240103000023IMarriage And Family TherapistFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 33068)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5092611384View full group profile
NameSpecialtyState
Nurse PractitionerGA
-GA
-GA
Clinical PsychologistGA
Nurse PractitionerGA
Clinical PsychologistGA
P S Y C H I A T R YGA
Mental Health CounselorTN
Mental Health CounselorGA
Clinical PsychologistGA

Reviews

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Frequently asked questions

What is ANGE-FENNIE JEAN (LMFT)'s NPI number?
ANGE-FENNIE JEAN (LMFT)'s NPI is 1356622781 — the number used across U.S. healthcare to identify this provider.
Is ANGE-FENNIE JEAN (LMFT) still an active registrant?
ANGE-FENNIE JEAN (LMFT) carries an active NPI according to the public dataset.
What clinical focus is listed for ANGE-FENNIE JEAN (LMFT)?
At a glance, ANGE-FENNIE JEAN (LMFT) is tied to Marriage & Family Therapist. Clinical services aligned with this taxonomy classification.
Is ANGE-FENNIE JEAN (LMFT) located near North Lauderdale?
ANGE-FENNIE JEAN (LMFT) currently maps to North Lauderdale, Florida in this extract.
When was this NPI issued?
Enumeration for ANGE-FENNIE JEAN (LMFT) is noted as August 30, 2011 where the registry provides it.

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