Active NPI
Jessica Simonetti
- Psychologist
- Mansfield, TX
National Provider Identifier
1255124772
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 40699
- Practice address
- 108 N 1St Ave
Mansfield, TX 76063-1602 - Phone
- (817) 592-0750
- NPI assigned
- May 27, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 40699 | TX | Primary |
Addresses
Primary practice location
108 N 1St Ave
Mansfield, TX 76063-1602
Mailing address
209 Lollipop TRL
Abilene, TX 79602-8331
Phone (325) 725-8664
Other names 1
- Ms. Jessica Boothe
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40699 | TX | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stanley Psychology PLLC | Current | 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": "1748304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1748304000000",
"number": "1255124772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "209 LOLLIPOP TRL",
"city": "ABILENE",
"state": "TX",
"postal_code": "796028331",
"telephone_number": "325-725-8664"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 N 1ST AVE",
"city": "MANSFIELD",
"state": "TX",
"postal_code": "760631602",
"telephone_number": "817-592-0750"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMONETTI",
"first_name": "JESSICA",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-05-27",
"last_updated": "2025-05-27",
"certification_date": "2025-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "TX",
"license": "40699",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JESSICA",
"last_name": "BOOTHE",
"prefix": "MS.",
"credential": "MS, LPA",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Mansfield, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.