Jennifer Lee Fast, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

38062 Issued in TX

Practice address

211 E 7TH St Ste 620
Austin, TX 78701-3218

Phone

(800) 370-3651

NPI assigned

May 11, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Jennifer Lee Jeziorski Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1462924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545177600000",
    "number": "1033565833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 CAMPUS CIR",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600452342",
            "telephone_number": "708-334-7508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 E 7TH ST STE 620",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787013218",
            "telephone_number": "800-370-3651"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "225 E Deerpath",
            "address_2": "Suite 280",
            "address_purpose": "LOCATION",
            "city": "Lake Forest",
            "state": "IL",
            "postal_code": "600451952",
            "country_code": "US",
            "telephone_number": "847-796-6400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAST",
        "first_name": "JENNIFER",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-11",
        "last_updated": "2018-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071008255",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "38062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "JEZIORSKI",
            "middle_name": "LEE",
            "prefix": "DR.",
            "credential": "PSY.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sam Drake Fason, M.D.
• Steven M Fass, M.D.
• Kameron Fassett
• Erin Fassnacht
• Mary Quinn Fassnacht, CPNP-PC
• Kelsey Ann Fath
• Mehrab Fathi, MD
• Kathryn Fattal, BCBA, LBA
• William John Fatzinger Jr., LPC ASSOCIATE
• Cierra Nicole Fauber-Ferrier

• Clinical Psychologist in Austin, TX
• Providers in Austin, TX by specialty
• Clinical Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.