Healthcare Provider Details

I. General information

NPI: 1821682626
Provider Name (Legal Business Name): JENNIFER WHEAT LMFT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2021
Last Update Date: 04/03/2025
Certification Date: 04/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

329 NOKOMIS AVE S STE H
VENICE FL
34285-2418
US

IV. Provider business mailing address

329 NOKOMIS AVE S STE H
VENICE FL
34285-2418
US

V. Phone/Fax

Practice location:
  • Phone: 317-250-0371
  • Fax:
Mailing address:
  • Phone: 317-250-0371
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER LOUISE WHEAT
Title or Position: OWNER
Credential:
Phone: 941-882-0101