Active NPI
Jenna Marie D'Agostini
- Clinical Psychologist
- Apex, NC
National Provider Identifier
1407527773
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 35SI00652000
- Practice address
- 1611 Brynmar Oaks Cir
Apex, NC 27539-3014 - Phone
- (973) 936-8034
- NPI assigned
- Sep 25, 2021
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 35SI00652000 | NJ | Primary |
Addresses
Primary practice location
1611 Brynmar Oaks Cir
Apex, NC 27539-3014
Mailing address
1611 Brynmar Oaks Cir
Apex, NC 27539-3014
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35SI00652000 | NJ | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1632528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1743811200000",
"number": "1407527773",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1611 BRYNMAR OAKS CIR",
"city": "APEX",
"state": "NC",
"postal_code": "275393014"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1611 BRYNMAR OAKS CIR",
"city": "APEX",
"state": "NC",
"postal_code": "275393014",
"telephone_number": "973-936-8034"
}
],
"practiceLocations": [],
"basic": {
"last_name": "D'AGOSTINI",
"first_name": "JENNA",
"middle_name": "MARIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-09-25",
"last_updated": "2025-04-05",
"certification_date": "2025-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NJ",
"license": "35SI00652000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Apex, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.