Jennifer Cooke Staat, P.a.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

2505 Issued in NC

Legal business name

JENNIFER COOKE STAAT, P.A.

Practice address

4608 Cedar Ave
Suite 106
Wilmington, NC 28403-4419

Phone

(910) 547-3093

NPI assigned

Aug 18, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Jennifer Cooke Staat, PH.D.

Title

Clinical Psychologist

Phone

(910) 547-3093

Specialties & licenses 1

Addresses

Other names 1

• Northstar Psychology Doing business as

Locations

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

{
    "created_epoch": "1219017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219017600000",
    "number": "1205083532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4608 CEDAR AVE",
            "address_2": "SUITE 106",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284034419",
            "telephone_number": "910-547-3093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4608 CEDAR AVE",
            "address_2": "SUITE 106",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284034419",
            "telephone_number": "910-547-3093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER COOKE STAAT, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-18",
        "last_updated": "2008-08-18",
        "status": "A",
        "authorized_official_last_name": "STAAT",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "COOKE",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "910-547-3093",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "NC",
            "license": "2505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northstar Psychology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Leah Jenkins, PHD,, LPC, NCC
• Madelyn Jenkins
• Melanie Jenkins, BCBA
• Tana B Jenkins, CRNA
• Travis Clarke Jenkins, MD
• Jennifer Herrmann Rd Ibclc
• Jennifer Upchurch LCSW PLLC
• Thomas Shannon Jennings II
• Rion Elizabeth Jenny, LCSWA
• Regina Marie Jensen, MD

• Psychologist in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2008; 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.