Individual provider Active NPI

Jessica Harley Wilson, PSY. D

  • Psychologist
  • Lexington, KY
National Provider Identifier
1508248980
Registry record updated Nov 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
1101 Veterans Dr
Lexington, KY 40502-2235
Phone
(859) 233-4511
NPI assigned
Jun 23, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X Primary

Addresses

Primary practice location

1101 Veterans Dr
Lexington, KY 40502-2235

Mailing address

1101 Vetrans Drive
US Department of Veterans Affairs
Lexington, KY 40502
Phone (859) 233-4511

Other names 1

  • Jessica Lynn Harley Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250812001145 SC Practitioner - Clinical Psychologist 9537667282 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1917SCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Che Behavioral Health Services of South Carolina, P.C. CurrentSince Jun 2, 2025 Accepting new patients

Locations

220 N Main St
Ste 500
Greenville, SC 29601
Phone (347) 294-3414

Organizations & group practices 1

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": "1435017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478649600000",
    "number": "1508248980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 VETRANS DRIVE",
            "address_2": "US DEPARTMENT OF VETERANS AFFAIRS",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "40502",
            "telephone_number": "859-233-4511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 VETERANS DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405022235",
            "telephone_number": "859-233-4511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JESSICA",
        "middle_name": "HARLEY",
        "name_prefix": "Dr.",
        "credential": "PSY. D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-23",
        "last_updated": "2016-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "HARLEY",
            "middle_name": "LYNN",
            "credential": "PSY. D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.