Jessica Lois Desrosiers, PSY.D.
Individual provider Active NPI Clinical Psychologist · Middletown, DE
NPI 1003096595 · NPPES record last updated Feb 3, 2016
Key facts
- NPI
- 1003096595
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 3303 (NC)
- Practice address
- 216 W Main St
Middletown, DE 19709 - Phone
- (443) 617-5152
- NPI assigned
- Nov 13, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
216 W Main St
Middletown, DE 19709-1041
Phone (443) 617-5152
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in DE
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160205000134 | DE | Practitioner - Clinical Psychologist | 2163726571 | Practice locations: Middletown, DE |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3303 | NC | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Delaware Podiatric Medicine PA | Past | Accepting new patients | |
| Soul-Full Presence LLC | Clinical | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 3303 | NC | Yes |
Addresses
Primary practice location
216 W Main St
Middletown, DE 19709
Mailing address
105 Nashua Court
Bear, DE 19701-3324
Phone (443) 617-5152
Other providers in Middletown, DE
- Virginia K. Dennis
- Dental Management Strategies LLC
- Priyal Desai
- Rowena Descartes
- Alfonda Deseignora
- Samuel Dewar
- Diamond State Surgical Associates,LLC
- Kassidy Diaz
- Lisa Dickinson
- Dih Camp
All providers in Middletown, DE · Clinical Psychologist in Delaware
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 3, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.