Individual provider Active NPI

Jessica Leigh Lawson, PH.D.

  • Clinical Psychologist
  • Darien, CT
National Provider Identifier
1154782589
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
003836 Issued in CT
Practice address
11 Queens LN
Darien, CT 06820-5420
Phone
(978) 760-0058
NPI assigned
Mar 12, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 003836 CT Primary
Clinical Psychologist 103TC0700X 024936-01 NY

Addresses

Primary practice location

11 Queens LN
Darien, CT 06820-5420

Mailing address

11 Queens LN
Darien, CT 06820-5420
Phone (978) 760-0058

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20250828003283 NY Practitioner - Clinical Psychologist 1153822440 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2017
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

11 Queens LN
Darien, CT 06820-5420

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
024936-01NYMDClinical Psychologist
003836CTMDClinical Social Worker
024936NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Amy D Wicker Psy D PLLC CurrentSince Jul 22, 2025 Accepting new patients

Locations

26 Court St
Ste 409
Brooklyn, NY 11242
Phone (212) 405-2685

Organizations & group practices 1

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": "1457740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742515200000",
    "number": "1154782589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 QUEENS LN",
            "city": "DARIEN",
            "state": "CT",
            "postal_code": "068205420",
            "telephone_number": "978-760-0058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 QUEENS LN",
            "city": "DARIEN",
            "state": "CT",
            "postal_code": "068205420",
            "telephone_number": "978-760-0058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWSON",
        "first_name": "JESSICA",
        "middle_name": "LEIGH",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-12",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "003836",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "024936-01",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Darien, CT

Sources for this page

Verify at the official NPI Registry.