MEDICARE: ANDREA JENNIFER PLLC

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1598607707
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANDREA JENNIFER PLLC

Provider Business Mailing Address
First Line	:	2842 LONG VIEW DR
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33761-3200
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	822 E WILLAMETTE AVE
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80903-2805
Country	:	US
Telephone Number	:	727-772-3308
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ANDREA MONGELLUZZI
Credential	:
Telephone Number	:	727-772-3308

Provider Enumeration Date	:	04/07/2026
Last Update Date	:	04/07/2026

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