Individual provider Active NPI

Jessica Ventura Caniff, PSYD

  • Clinical Psychologist
  • Lexington, KY
National Provider Identifier
1508559493
Registry record updated May 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
281703 Issued in KY
Practice address
161 Prosperous PL
Lexington, KY 40509-1898
Phone
(859) 214-7440
NPI assigned
May 29, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 281703 KY Primary

Addresses

Primary practice location

161 Prosperous PL
Lexington, KY 40509-1898

Mailing address

161 Prosperous PL Ste 100
Lexington, KY 40509-1898

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20230712003687 KY Practitioner - Clinical Psychologist 4688034465 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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": "1685318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685318400000",
    "number": "1508559493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 PROSPEROUS PL STE 100",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405091898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 PROSPEROUS PL",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405091898",
            "telephone_number": "859-214-7440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANIFF",
        "first_name": "JESSICA",
        "middle_name": "VENTURA",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-29",
        "last_updated": "2023-05-29",
        "certification_date": "2023-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KY",
            "license": "281703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.