Jovial Mental Health LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

JOVIAL MENTAL HEALTH LLC

Practice address

2613 Lakewood Dr
Dyer, IN 46311-2133

Phone

(626) 554-0408

NPI assigned

May 10, 2023

Organization subpart

No

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

Authorized official

Name

Jennifer D'Agostino, PSY DNPI 1528547494

Title

Ceo

Phone

(626) 554-0408

Specialties & licenses 1

Addresses

Other names 1

• Jovial Mental Health LLC Former legal business name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jennifer D'Agostino

  • Clinical Psychologist
  • Dyer, IN
  • NPI 1528547494
  NPD Authorized official

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

{
    "created_epoch": "1683676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1477243715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2613 LAKEWOOD DR",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463112133",
            "telephone_number": "626-554-0408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2613 LAKEWOOD DR",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463112133",
            "telephone_number": "626-554-0408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOVIAL MENTAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-10",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A",
        "authorized_official_last_name": "D'AGOSTINO",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "626-554-0408",
        "authorized_official_credential": "PSY D"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jovial Mental Health LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Clinical Psychologist in Dyer, IN
• Providers in Dyer, IN by specialty
• Clinical Psychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.