MEDICARE: JENNIFER L FLOOD, LMFT, LPCC'S MARRIAGE AND FAMILY COUNSELING GROUP, I

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

General Provider Information

NPI Number	:	1598486359
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JENNIFER L FLOOD, LMFT, LPCC'S MARRIAGE AND FAMILY COUNSELING GROUP, I

Provider Business Mailing Address
First Line	:	2335 AMERICAN RIVER DR STE 301
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95825-7088
Country	:	US
Telephone Number	:	530-213-3444
Fax Number	:	916-357-8630

Provider Business Practice Location Address
First Line	:	2335 AMERICAN RIVER DR STE 301
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95825-7088
Country	:	US
Telephone Number	:	530-213-3444
Fax Number	:	916-357-8630

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MISS MELISSA DILLON
Credential	:
Telephone Number	:	530-213-3444

Provider Enumeration Date	:	09/08/2022
Last Update Date	:	09/08/2022

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