Individual provider Active NPI

Jessica Shenesey, PH.D.

  • Clinical Psychologist
  • Mobile, AL
National Provider Identifier
1225386162
Registry record updated Jul 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1858 Issued in AL
Practice address
5 Dauphin St Ste 201
Mobile, AL 36602-3242
Phone
(251) 512-5026
Fax
(251) 277-2494
NPI assigned
Aug 27, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1858 AL Primary

Addresses

Primary practice location

5 Dauphin St Ste 201
Mobile, AL 36602-3242

Mailing address

5 Dauphin St Ste 201
Mobile, AL 36602-3242
Phone (251) 512-5026

Other practice location 1

273 Azalea Rd
Suite 2-413
Mobile, AL 36609-1970
Phone (251) 343-0566

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20140122000734 AL Practitioner - Clinical Psychologist 7113155037 Practice locations: Mobile, AL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
University of South Alabama College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

273 Azalea Rd
Suite 2/413
Mobile, AL 36609-1913

3929 Airport Blvd
Suite 2 413
Mobile, AL 36609-2239
Phone (251) 343-0566

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
John W Davis, PH.D. Clinical Past Accepting new patients

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": "1346025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1225386162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 DAUPHIN ST STE 201",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366023242",
            "telephone_number": "251-512-5026",
            "fax_number": "251-277-2494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 DAUPHIN ST STE 201",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366023242",
            "telephone_number": "251-512-5026",
            "fax_number": "251-277-2494"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "273 Azalea Rd",
            "address_2": "Suite 2-413",
            "address_purpose": "LOCATION",
            "city": "Mobile",
            "state": "AL",
            "postal_code": "366091970",
            "country_code": "US",
            "telephone_number": "251-343-0566",
            "fax_number": "251-343-0120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHENESEY",
        "first_name": "JESSICA",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-27",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AL",
            "license": "1858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.