Individual provider Active NPI

Jessica Kathleen Shevlin, AMFT

  • Marriage & Family Therapist
  • Lancaster, CA
National Provider Identifier
1366206369
Registry record updated Feb 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
AMFT125197 Issued in CA
Practice address
815 W Lancaster Blvd # 115
Lancaster, CA 93534-2303
Phone
(661) 903-8822
NPI assigned
Feb 9, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X AMFT125197 CA Primary

Addresses

Primary practice location

815 W Lancaster Blvd # 115
Lancaster, CA 93534-2303

Mailing address

815 W Lancaster Blvd # 115
Lancaster, CA 93534-2303
Phone (661) 903-8822

Other names 1

  • Jessica Kathleen Coupland Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250113002639 CA Practitioner - Marriage and Family Therapist 8224566690 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Real Road IncGroup PAC ID 1052858396, 16 clinicians

Practice addresses (Care Compare)

815 W Lancaster Blvd
Suite 115
Lancaster, CA 93534-2303
Phone (661) 903-8822

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AMFT125197CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Solutions Family Therapy Center Inc. CurrentSince Jan 1, 2025 Accepting new patients

Locations

815 W Lancaster Blvd
Ste 115
Lancaster, CA 93534
Phone (661) 903-8822

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": "1707436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1366206369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 W LANCASTER BLVD # 115",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342303",
            "telephone_number": "661-903-8822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 W LANCASTER BLVD # 115",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342303",
            "telephone_number": "661-903-8822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEVLIN",
        "first_name": "JESSICA",
        "middle_name": "KATHLEEN",
        "credential": "AMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-09",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "AMFT125197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "COUPLAND",
            "middle_name": "KATHLEEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lancaster, CA

Sources for this page

Verify at the official NPI Registry.