Active NPI
Lisa Renee Jepson, PH.D.
- Psychologist
- East Islip, NY
National Provider Identifier
1346574761
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 013756-1
- Practice address
- 23 Brook PL
East Islip, NY 11730-1001 - Phone
- (631) 581-3081
- Fax
- (631) 581-3081
- NPI assigned
- Oct 1, 2009
- Sex
- Female
- Sole proprietor
- Yes
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 | 013756-1 | NY | Primary |
Addresses
Primary practice location
23 Brook PL
East Islip, NY 11730-1001
Mailing address
23 Brook PL
East Islip, NY 11730-1001
Phone (631) 581-3081
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130202000054 | NY | Practitioner - Clinical Psychologist | 0941454763 | Practice locations: East Islip, NY |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 013756-1 | NY | MD | Speech-Language Pathologist |
| 013756 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1254355200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1254355200000",
"number": "1346574761",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23 BROOK PL",
"city": "EAST ISLIP",
"state": "NY",
"postal_code": "117301001",
"telephone_number": "631-581-3081",
"fax_number": "631-581-3081"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23 BROOK PL",
"city": "EAST ISLIP",
"state": "NY",
"postal_code": "117301001",
"telephone_number": "631-581-3081",
"fax_number": "631-581-3081"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEPSON",
"first_name": "LISA",
"middle_name": "RENEE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-10-01",
"last_updated": "2009-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "013756-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Islip, NY
- James Greico P.T.,M.S.
- James W Ferguson MD LLC
- Kiera Marie Javino, RN
- Jay B. Stambler MD PC
- Christela M Jean Baptiste
- Jodianne Fitzgerald Licensed Mental Health Counselor PC
- John Cody Occupational Therapy Services, P.C.
- John F. Dimitri, DC, PLLC
- John Mroz Psychiatric Nurse Practitioner PLLC
- Christopher Juzumas, LMHC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.