Individual provider Active NPI

Jennifer Parks, PSYD

  • Psychologist
  • Newark, OH
National Provider Identifier
1225538333
Registry record updated Sep 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
P.07790 Issued in OH
Practice address
68 W Church St Ste 318
Newark, OH 43055-5050
Phone
(740) 281-1777
NPI assigned
Feb 15, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X P.07790 OH Primary
Marriage & Family Therapist 106H00000X

Addresses

Primary practice location

68 W Church St Ste 318
Newark, OH 43055-5050

Mailing address

7409 Manor Creek Loop
New Albany, OH 43054-8822

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20190912002325 IL Practitioner - Clinical Psychologist 6204189699 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Samaritan Interfaith Counseling Center IncGroup PAC ID 8426014994, 19 clinicians

Practice addresses (Care Compare)

1819 Bay Scott Cir
Suite 109
Naperville, IL 60540-1130
Phone (630) 357-2456

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Interfaith Counseling Center Inc. CurrentSince May 1, 2024 Accepting new patients
Mid-Ohio Psychological Services Inc Psychologist CurrentSince Oct 5, 2021 Accepting new patients
Samaritan Counseling Center Marriage & Family Therapist Past Accepting new patients

Locations

1819 Bay Scott Cir
Ste 109
Naperville, IL 60540
Phone (630) 357-2456

1761 S Naperville Rd
Ste 200
Wheaton, IL 60189
Phone (630) 260-0606

106 Starret St
Ste 100
Lancaster, OH 43130
Phone (740) 687-0042

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": "1518652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537315200000",
    "number": "1225538333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7409 MANOR CREEK LOOP",
            "city": "NEW ALBANY",
            "state": "OH",
            "postal_code": "430548822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 W CHURCH ST STE 318",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430555050",
            "telephone_number": "740-281-1777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKS",
        "first_name": "JENNIFER",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-15",
        "last_updated": "2018-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "P.07790",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, OH

Sources for this page

Verify at the official NPI Registry.