Individual provider Active NPI

Jamie Lee Stashko, PSY.D.

  • Clinical Psychologist
  • Apex, NC
National Provider Identifier
1477898724
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
5063 Issued in NC
Practice address
201 S Salem St
Apex, NC 27502-1824
Phone
(919) 303-0377
Fax
(919) 267-6173
NPI assigned
Nov 27, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X
Clinical Psychologist 103TC0700X 5063 NC Primary

Addresses

Primary practice location

201 S Salem St
Apex, NC 27502-1824

Mailing address

201 S Salem St
Apex, NC 27502-1824
Phone (919) 303-0377

Other practice location 1

275 Belmont St
Worcester, MA 01604-1675
Phone (508) 421-4494

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Previously, effective Aug 19, 2024 through Aug 19, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5063NCMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Child and Family Psychological Services, PLLC Psychologist PastSince Sep 19, 2018 Accepting new patients
Peak Development Associates Psychologist PastSince Jul 24, 2022 Accepting new patients

Organizations & group practices 2

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": "1353974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1477898724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 S SALEM ST",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275021824",
            "telephone_number": "919-303-0377",
            "fax_number": "919-267-6173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S SALEM ST",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275021824",
            "telephone_number": "919-303-0377",
            "fax_number": "919-267-6173"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "275 Belmont St",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016041675",
            "country_code": "US",
            "telephone_number": "508-421-4494",
            "fax_number": "508-795-1338",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STASHKO",
        "first_name": "JAMIE",
        "middle_name": "LEE",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-27",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "5063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apex, NC

Sources for this page

Verify at the official NPI Registry.