Individual provider Active NPI

Jenna Cleversley, PSYD

  • Psychologist
  • Louisville, KY
National Provider Identifier
1528816683
Registry record updated Nov 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
026859 Issued in NY
Practice address
220 Abraham Flexner Way
Louisville, KY 40202-3826
Phone
(502) 582-7484
NPI assigned
May 13, 2024
Last updated
Nov 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 026859 NY Primary

Addresses

Primary practice location

220 Abraham Flexner Way
Louisville, KY 40202-3826

Mailing address

601 Elmwood Ave Box 664
Rochester, NY 14642-0001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20250225002977 NY Practitioner - Clinical Psychologist 9133649841 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

601 Elmwood Ave
Rochester, NY 14642-0001
Phone (585) 275-3271

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
026859NYMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Rochester CurrentSince Dec 22, 2024 Accepting new patients
University of Rochester Physical Medicine and Rehabilitation CurrentSince Mar 25, 2025 Accepting new patients
Cardiac Surgery of the University of Rochester Current Accepting new patients
University of Rochester Current Accepting new patients
Acute Care Trauma of the University of Rochester Current Accepting new patients
University of Rochester CurrentSince Dec 22, 2024 Accepting new patients

Locations

5901 Lac de Ville Blvd
#250
Rochester, NY 14618
Phone (585) 275-3271

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

601 Elmwood Ave
#664
Rochester, NY 14642
Phone (585) 275-3271

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1715558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730419200000",
    "number": "1528816683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE BOX 664",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 ABRAHAM FLEXNER WAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402023826",
            "telephone_number": "502-582-7484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEVERSLEY",
        "first_name": "JENNA",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-13",
        "last_updated": "2024-11-01",
        "certification_date": "2024-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "026859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.