Individual provider Active NPI

Jessika Brasseaux, APRN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • New Haven, CT
National Provider Identifier
1346611852
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
6319 Issued in CT
Practice address
50 Brewery St Unit 9138
New Haven, CT 06511-5954
Phone
(203) 903-9797
Fax
(844) 440-2333
NPI assigned
Oct 9, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 113883 CT
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 6319 CT Primary

Addresses

Primary practice location

50 Brewery St Unit 9138
New Haven, CT 06511-5954

Mailing address

PO Box 9138
New Haven, CT 06532-0138
Phone (203) 903-9797

Other practice location 1

20 York St
New Haven, CT 06510-3220
Phone (203) 688-4242

Other identifiers 1

IdentifierTypeStateIssuer
1750973152OtherNPI 2

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective May 1, 2023 through May 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
113883CTMDPsychiatric/Mental Health Registered Nurse

Interoperability endpoints

  • Direct secure messaging: jbrasseaux104894@direct.ynhh.org

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1444348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1346611852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9138",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065320138",
            "telephone_number": "203-903-9797",
            "fax_number": "844-440-2333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 BREWERY ST UNIT 9138",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065115954",
            "telephone_number": "203-903-9797",
            "fax_number": "844-440-2333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 York St",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065103220",
            "country_code": "US",
            "telephone_number": "203-688-4242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRASSEAUX",
        "first_name": "JESSIKA",
        "credential": "APRN, PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-09",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CT",
            "license": "113883",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "6319",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI 2",
            "identifier": "1750973152",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.