JENNIFER CALDWELL (MA) – Mental Health Counselor, NPI 1417134537

JENNIFER CALDWELL (MA) is a healthcare provider. based in Brandon, Florida. specializing in Mental Health Counselor. They hold the professional credentials MA. They hold a License No. MH11890 (FL). The NPI Number for JENNIFER CALDWELL (MA) is 1417134537

Main info

Female
Sole Proprietor
Name
JENNIFER CALDWELL (MA)
NPI
1417134537
Phone
(813) 881-1000
Address
510 VONDERBURG DR
Enumeration Date
31 January 2008
Last Update Date
14 December 2022
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience65
Completeness75
Years active:18State licenses:1Digital endpointsOther names

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Provider Addresses for JENNIFER CALDWELL (MA)

  • 510, Vonderburg Drive, Brandon, Hillsborough County, Florida, 33511, United States

    BRANDON, FL 335115954

    Phone: (813) 881-1000

    Type: Mailing

  • 5 REVERE DR STE 120

    NORTHBROOK, IL 600628005

    Phone: (941) 485-0121

    Fax: (941) 485-0591

    Type: Mailing

  • 417 COMMERCIAL CT STE C

    VENICE, FL 342921655

    Phone: (941) 485-0121

    Fax: (941) 485-0591

    Type: Location

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: 2024-01-10

PECOS data refreshed: 2026-05-27

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
I20240110000100IMental Health CounselorFLTBD

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

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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 33511)

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Reviews

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Frequently asked questions

How do I look up JENNIFER CALDWELL (MA) by NPI?
Use NPI 1417134537 when you need to reference JENNIFER CALDWELL (MA) in forms, claims, or directories.
Is JENNIFER CALDWELL (MA) currently active in the NPI registry?
CMS-published data lists JENNIFER CALDWELL (MA) as an active registrant.
Can you summarize JENNIFER CALDWELL (MA)'s specialty in plain language?
Clinically, the directory lists JENNIFER CALDWELL (MA) with Mental Health Counselor. Clinical services aligned with this taxonomy classification.
What location metadata exists for JENNIFER CALDWELL (MA)?
The page summarizes Brandon, Florida for JENNIFER CALDWELL (MA); expand the address list for detail.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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