Judy Corrinne Jagiello, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY61497403 Issued in WA

Practice address

1404 E 11TH Ave
Spokane, WA 99202-3502

Phone

(509) 744-1117

NPI assigned

Jun 27, 2016

Sex

Unspecified or another gender identity

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mindful Therapy Group PCGroup PAC ID 4981872561, 654 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mindful Therapy Group PC

  • Clinical Social Worker
  • Mountlake Terrace, WA
  • NPI 1316238678

  Mental Health

  Medicare reassignment Care Compare group NPD
• Harrison Renfrew LLC Dba Center for Family Development

  • Mental Health Counselor
  • Spokane, WA
  • NPI 1609914803
  NPD (past)
• Pacific University

  • Adult Mental Health Clinic/Center
  • Hillsboro, OR
  • NPI 1700256989
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1466985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1023469442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N HOWARD ST STE W",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992010508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1404 E 11TH AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992023502",
            "telephone_number": "509-744-1117"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 W North River Dr Ste 301",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992012262",
            "country_code": "US",
            "telephone_number": "509-903-0103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAGIELLO",
        "first_name": "JUDY",
        "middle_name": "CORRINNE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2016-06-27",
        "last_updated": "2024-07-31",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY61497403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teresa Jacobson
• Kathryn Jacot, PA-C
• David Lee Jacques, PTA
• Alexa Marie Jaeger, MD
• April R Jaeger, MD
• Marisity Arrin Jagim-Kern, LICSWA
• Courtney Jane Jahay, NAR
• Julie M Jahn, M.S., CCC-SLP
• Araceli Jaime
• Mohit Jain, MD

• Clinical Psychologist in Spokane, WA
• Providers in Spokane, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.