JENCYMOL MATHEW APRN PMHNP NPI 1457008872

NPI Information

  • NPI: 1457008872
  • Provider Name: JENCYMOL MATHEW, APRN, PMHNP
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 8136 CENTRALIA CT STE 101
    LEESBURG, FL
    ZIP 34788
  • Phone: (800) 614-4124

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NPI Details

Jencymol Mathew, APRN, PMHNP is a psychiatric/mental health nurse practitioner in Leesburg, FL. Jencymol Mathew, APRN, PMHNP NPI is 1457008872. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

8136 CENTRALIA CT STE 101
LEESBURG, FL
ZIP 34788-757
Phone: (800) 614-4124

The NPI 1457008872 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/5/2022 and was last updated on 11/7/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0808XNurse PractitionerPsychiatric/Mental HealthAPRN11018479FLORIDAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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