Active NPI
Jessica Ashley Sergio, PH.D.
- Counseling Psychologist
- Fulton, MO
National Provider Identifier
1376803619
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 2010036635
- Practice address
- 600 E 5TH St
Fulton, MO 65251-1753 - Phone
- (573) 592-2628
- NPI assigned
- May 21, 2012
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 2010036635 | MO | Primary |
Addresses
Primary practice location
600 E 5TH St
Fulton, MO 65251-1753
Mailing address
600 E 5TH St
Fulton, MO 65251-1753
Phone (573) 592-2628
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)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1337558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1372809600000",
"number": "1376803619",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 E 5TH ST",
"city": "FULTON",
"state": "MO",
"postal_code": "652511753",
"telephone_number": "573-592-2628"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 E 5TH ST",
"city": "FULTON",
"state": "MO",
"postal_code": "652511753",
"telephone_number": "573-592-2628"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SERGIO",
"first_name": "JESSICA",
"middle_name": "ASHLEY",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-05-21",
"last_updated": "2013-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "MO",
"license": "2010036635",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fulton, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 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.