Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jean Elyse Dievendorf

Individual provider Mental Health Counselor · NPI 1184173981

Jean Elyse Dievendorf is a Clinical Social Worker in Palm Bay, Florida. Qualified in 2017, 9 years ago. Works from 4 locations and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
9
Licensed in
FL
In the registry since
2016
Specialties on file
3
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Practice location Address checks out

6050 Babcock St SE Ste 32
Palm Bay, FL 32909-4205
Phone: (321) 684-8265
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (3)

  • 4630 Lipscomb St Ne Ste 1a, Palm Bay, FL 32905-2940 — (321) 405-2583
  • 2475 Palm Bay Rd Ne, Palm Bay, FL 32905 — (321) 405-2583
  • 1127 S Patrick Dr, Satellite Beach, FL 32937-3939 — (321) 773-1111

Specialties & licences

Social Worker (primary) Taxonomy 104100000X
Mental Health Counselor Taxonomy 101YM0800X · Licence SW16874 (FL)
Clinical Social Worker Taxonomy 1041C0700X · Licence SW16874 (FL)

Record details

NPI number1184173981
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedSeptember 22, 2016
Last updated in NPPESFebruary 14, 2024
Certification dateFebruary 14, 2024
Mailing address2257 Whiteside Ave Se, Palm Bay, FL 32909-6044

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Palm Bay