Individual provider Active NPI

Jennifer L. Tzoumas, PHD

  • Cognitive & Behavioral Psychologist
  • Wyomissing, PA
National Provider Identifier
1174616239
Registry record updated Mar 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X
Practice address
2201 Ridgewood Road
Suite 400
Wyomissing, PA 19610-6977
Phone
(610) 378-9601
Fax
(610) 378-3610
NPI assigned
Oct 2, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2008

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X Primary
Counseling Psychologist 103TC1900X PS-015310 PA
Family Psychologist 103TF0000X

Addresses

Primary practice location

2201 Ridgewood Road
Suite 400
Wyomissing, PA 19610-6977

Mailing address

2201 Ridgewood Road
Suite 400
Wyomissing, PA 19610-6977
Phone (610) 378-9601

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20200604001550 TX Practitioner - Clinical Psychologist 9436197209 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

192 Concho Creek Loop
Leander, TX 78641-4226
Phone (512) 798-3444

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PS-015310PAMDCounseling Psychologist
37969TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Creative Solutions Behavioral Health, PLLC CurrentSince Mar 18, 2019 Accepting new patients
Reading Professional Services Past Accepting new patients
Tower Health Medical Group Past Accepting new patients

Locations

1464 E Whitestone Blvd
Ste 1901
Cedar Park, TX 78613
Phone (512) 470-8910

Organizations & group practices 3

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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206316800000",
    "number": "1174616239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 RIDGEWOOD ROAD",
            "address_2": "SUITE 400",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196106977",
            "telephone_number": "610-378-9601",
            "fax_number": "610-378-3610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 RIDGEWOOD ROAD",
            "address_2": "SUITE 400",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196106977",
            "telephone_number": "610-378-9601",
            "fax_number": "610-378-3610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TZOUMAS",
        "first_name": "JENNIFER",
        "middle_name": "L.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2008-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "PA",
            "license": "PS-015310",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyomissing, PA

Sources for this page

Verify at the official NPI Registry.