Jessica Clement

Primary specialty

PsychologistTaxonomy code 103T00000X

License

10043 Issued in MA

Practice address

40 Canoe Club LN
Pembroke, MA 02359-1888

Phone

(857) 225-9544

NPI assigned

Jun 8, 2016

Last updated

Mar 5, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Gray-Fin Consulting

  • Psychologist
  • Pembroke, MA
  • NPI 1083411367
  NPD Authorized official
• Kelley Costello, LMFT, Inc.

  • Marriage & Family Therapist
  • Attleboro, MA
  • NPI 1164029344

  Mental Health

  NPD (past)

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

{
    "created_epoch": "1465344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1508215724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 CANOE CLUB LN",
            "city": "PEMBROKE",
            "state": "MA",
            "postal_code": "023591888",
            "telephone_number": "857-225-9544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 CANOE CLUB LN",
            "city": "PEMBROKE",
            "state": "MA",
            "postal_code": "023591888",
            "telephone_number": "857-225-9544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMENT",
        "first_name": "JESSICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-08",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "10043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charm Medical Supply, Inc.
• Nan Chen, DMD
• Robert S Clark, DDS
• Jennifer Cleary, MSW, LCSW
• Lauren Cleary
• Tai Coburn
• Rachel S Cohen, LICSW
• Marcos Antonio Coli Jr.
• Michelle Ann Coner, NP
• Jeanine Marie Connolly, MS, ATC/L

• Psychologist in Pembroke, MA
• Providers in Pembroke, MA by specialty
• Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 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.

Verify at the official NPI Registry.