Provider Demographics
NPI:1649905829
Name:BASSETT, JENNIFER L (LMFT, MCAP, CMHP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:BASSETT
Suffix:
Gender:F
Credentials:LMFT, MCAP, CMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:813 SIGSBEE ROAD
Mailing Address - Street 2:PMB NO. 48
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33040-6700
Mailing Address - Country:US
Mailing Address - Phone:305-741-5065
Mailing Address - Fax:
Practice Address - Street 1:813 SIGSBEE ROAD
Practice Address - Street 2:PMB NO. 48
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040
Practice Address - Country:US
Practice Address - Phone:305-741-5065
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-20
Last Update Date:2023-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCBHCMS.0100649171M00000X
FLMT4770106H00000X
FLMCAP100355101YA0400X
FLCMHP.0100014106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician