Jessica E Borushok, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6294 Issued in NC

Practice address

1026 Jay St # B181
Charlotte, NC 28208-4431

Phone

(704) 313-8803

NPI assigned

Apr 14, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Sep 27, 2022 through Sep 27, 2026

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Busy Mind Psychologist Inc

  • Psychologist
  • Charlotte, NC
  • NPI 1780276402
  NPD Authorized official
• The Act Therapist PLLC

  • Clinical Psychologist
  • Charlotte, NC
  • NPI 1881569580
  NPD Authorized official

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

{
    "created_epoch": "1649894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1366185779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1026 JAY ST # B181",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282084431",
            "telephone_number": "704-313-8803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1026 JAY ST # B181",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282084431",
            "telephone_number": "704-313-8803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORUSHOK",
        "first_name": "JESSICA",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-14",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "6294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ruthie Borrelli
• Thor Erik Borresen, MD
• Christin Marie Borsenik, M.A.
• Adriana Rose Bortny
• Kristina Claire Borus, NP
• Mary Kathleen Rogers Boruta, MD
• Richard Justin Boruta, MD
• Rebecca Bosch
• Joan Bose, RNFA
• Clarence W. Boshamer, LPC

• Clinical Psychologist in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Clinical Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.