Jennifer Leigh Spillman, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

39115 Issued in TX

Practice address

233 SGT Ed Holcomb Blvd S
Conroe, TX 77304-1990

Phone

(936) 521-6100

Fax

(936) 760-2898

NPI assigned

May 17, 2007

Last updated

Jan 4, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Tri-County Behavioral HealthcareGroup PAC ID 5991754772, 15 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Tri-County Behavioral Healthcare

  • Multi-Specialty Clinic/Center
  • Conroe, TX
  • NPI 1851333074
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1073720876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3067",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773053067",
            "telephone_number": "936-521-6100",
            "fax_number": "936-760-2898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 SGT ED HOLCOMB BLVD S",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773041990",
            "telephone_number": "936-521-6100",
            "fax_number": "936-760-2898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPILLMAN",
        "first_name": "JENNIFER",
        "middle_name": "LEIGH",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "39115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164521003",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sparta Wellness
• Anthony Tyler Spates, DDS
• Rebecca Danielle Spaulding, LPC
• Speech Boulevard, LLC
• Stephanie Spencer, FNP-C
• Spine Wellness Centers
• Spring Anesthesia PLLC
• Spring Creek Urology Specialists LLC
• Kayla Brianne Springer
• Katherine Sralla, M.S. CCC-SLP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 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.