MEDICARE: DR. SEAN PATRICK JENNINGS PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	MH6241	FL
2	103T00000X	Psychologist	PY6877	FL
3	103TC0700X	Clinical Psychologist	PY6877	FL
4	103TC2200X	Clinical Child & Adolescent Psychologist	PY6877	FL
5	103TF0000X	Family Psychologist	PY6877	FL

General Provider Information

NPI Number	:	1528278611
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SEAN PATRICK JENNINGS PSY.D.

Provider Business Mailing Address
First Line	:	108 ROBIN RD STE 2006
Second Line	:
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32701-5035
Country	:	US
Telephone Number	:	407-831-2880
Fax Number	:	407-831-2881

Provider Business Practice Location Address
First Line	:	108 ROBIN RD STE 2006
Second Line	:
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32701-5035
Country	:	US
Telephone Number	:	407-831-2880
Fax Number	:	407-831-2881

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2007
Last Update Date	:	09/11/2025

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