Provider Demographics
NPI:1487294484
Name:JENNIFER MARSHA LLC
Entity type:Organization
Organization Name:JENNIFER MARSHA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:GENEUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-801-9185
Mailing Address - Street 1:1925 SAND ARBOR CIR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32824-4753
Mailing Address - Country:US
Mailing Address - Phone:321-947-0068
Mailing Address - Fax:
Practice Address - Street 1:2431 ALOMA AVE STE 127
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-2541
Practice Address - Country:US
Practice Address - Phone:407-801-9185
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-08
Last Update Date:2024-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty