Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

JENNIFER L. THIBODEAUX, PLLC
NPI 1093246589
Psychologist - Clinical in St Petersburg, FL

Q: What is Jennifer L. Thibodeaux, PLLC's NPI number?

The NPI number for Jennifer L. Thibodeaux, PLLC is 1093246589. It was assigned to this organization in the NPPES registry on March 25, 2017.

Q: What is Jennifer L. Thibodeaux, PLLC's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Active since March 25, 2017

2429 CENTRAL AVE STE 208, ST PETERSBURG, FL 33713(727) 610-2395(727) 933-0399 Get Directions Write a Review

NPPES record last updated: September 8, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 8, 2026, Mar 25, 2017 (2 updates tracked since 2017).

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About Jennifer L. Thibodeaux, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JENNIFER L. THIBODEAUX, PLLC (NPI 1093246589) is a healthcare organization registered as a clinical in St Petersburg, Florida and active in the NPI registry since March 2017. The organization lists Jennifer L Thibodeaux, Owner, as its authorized official.

NPPES Registry Identity

NPI1093246589

Entity TypeOrganization

Primary Taxonomy103TC0700X

Legal Business NameJENNIFER L. THIBODEAUX, PLLC

Location Address2429 CENTRAL AVE STE 208St Petersburg, FL 33713-8848

Mailing Address2429 Central Ave Ste 208St Petersburg, FL 33713-8848 · (727) 610-2395 · Fax (727) 933-0399

Phone(727) 610-2395

Fax(727) 933-0399

Organization SubpartNo

Authorized OfficialJennifer L ThibodeauxOwner · (727) 610-2395

Enumeration DateMarch 25, 2017

Last NPPES UpdateSeptember 8, 20262 updates tracked since enumeration

NPPES CertifiedSeptember 8, 2026

✔ NPI 1093246589 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in FL · PY9698

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

2429 CENTRAL AVE STE 208, St Petersburg, FL 33713

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jennifer L. Thibodeaux, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Jennifer L. Thibodeaux, PLLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Jennifer Thibodeaux, PH.D.

Clinical Psychologist

NPI 1013467919

2429 CENTRAL AVE STE 208
Saint Petersburg, FL 33713

(727) 610-2395

✔ PECOSSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jennifer L. Thibodeaux, PLLC's NPI number?

The NPI number for Jennifer L. Thibodeaux, PLLC is 1093246589. It was assigned to this organization in the NPPES registry on March 25, 2017.

Where is Jennifer L. Thibodeaux, PLLC located?

Jennifer L. Thibodeaux, PLLC is located at 2429 Central Ave Ste 208, St Petersburg, FL 33713. The listed phone number is (727) 610-2395.

What is Jennifer L. Thibodeaux, PLLC's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Jennifer L. Thibodeaux, PLLC enrolled in Medicare?

Yes. Jennifer L. Thibodeaux, PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Jennifer L. Thibodeaux, PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Psychologist) reassigns their Medicare billing to Jennifer L. Thibodeaux, PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Jennifer L. Thibodeaux, PLLC was last updated on September 8, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 44 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.