Individual provider Active NPI

Jennifer Ann Braun, PSYD, HSPP

  • Clinical Psychologist
  • Evansville, IN
National Provider Identifier
1083919799
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
20043183B Issued in IN
Practice address
1931 Lincoln Ave
Evansville, IN 47714-1507
Phone
(812) 488-5640
NPI assigned
Jan 12, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 261Q00000X CA
Clinical Psychologist 103TC0700X 20043183B IN Primary

Addresses

Primary practice location

1931 Lincoln Ave
Evansville, IN 47714-1507

Mailing address

1931 Lincoln Ave
Evansville, IN 47714-1507

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20190315000718 IN Practitioner - Clinical Psychologist 3971843665 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20043183BINMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Evansville CurrentSince May 15, 2025 Accepting new patients
Wright Institute Past Accepting new patients

Locations

1931 Lincoln Ave
#A
Evansville, IN 47714
Phone (812) 488-3350

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1294790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1083919799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1931 LINCOLN AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477141507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1931 LINCOLN AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477141507",
            "telephone_number": "812-488-5640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAUN",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PSYD, HSPP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-12",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "261Q00000X",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20043183B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.