MEDICARE: MS. JODI R. NEVERS LMFT

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	106H00000X	Marriage & Family Therapist	MT 1655	FL
2	106H00000X	Marriage & Family Therapist	MT1655	FL

General Provider Information

NPI Number	:	1376605527
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JODI R. NEVERS LMFT

Provider Business Mailing Address
First Line	:	5020 SOMERSBY RD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32217-4836
Country	:	US
Telephone Number	:	386-614-2396
Fax Number	:	360-262-2932

Provider Business Practice Location Address
First Line	:	5020 SOMERSBY RD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32217-4836
Country	:	US
Telephone Number	:	386-614-2396
Fax Number	:	360-262-2932

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

Provider Enumeration Date	:	12/14/2006
Last Update Date	:	12/13/2022

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