Active NPI
Jessica Young Pae, PSY.D.
- Clinical Psychologist
- Littleton, CO
National Provider Identifier
1306186119
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY.0003870
- Practice address
- 7921 Southpark PLZ
Suite 204
Littleton, CO 80120-5630 - Phone
- (720) 489-8555
- Fax
- (720) 489-8304
- NPI assigned
- Feb 15, 2013
- Last updated
- May 10, 2013
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | NU | ||
| Clinical Psychologist | 103TC0700X | PSY.0003870 | CO | Primary |
Addresses
Primary practice location
7921 Southpark PLZ
Suite 204
Littleton, CO 80120-5630
Mailing address
7921 Southpark PLZ
Suite 204
Littleton, CO 80120-5630
Phone (720) 489-8555
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 |
|---|---|---|---|
| PSY.0003870 | CO | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grace Counseling, Inc. | Mental Health | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1360886400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1368144000000",
"number": "1306186119",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7921 SOUTHPARK PLZ",
"address_2": "SUITE 204",
"city": "LITTLETON",
"state": "CO",
"postal_code": "801205630",
"telephone_number": "720-489-8555",
"fax_number": "720-489-8304"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7921 SOUTHPARK PLZ",
"address_2": "SUITE 204",
"city": "LITTLETON",
"state": "CO",
"postal_code": "801205630",
"telephone_number": "720-489-8555",
"fax_number": "720-489-8304"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAE",
"first_name": "JESSICA",
"middle_name": "YOUNG",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-02-15",
"last_updated": "2013-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CO",
"license": "PSY.0003870",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Littleton, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.