Jennifer L Bellissimo, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

11668 Issued in MA

Practice address

6 Belmont Dr
Chelmsford, MA 01824-4802

Phone

(978) 551-3448

NPI assigned

Sep 9, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MA

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

Specialty

Clinical Psychologist

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Jeanom LLC

  • Mental Health Counselor
  • Woburn, MA
  • NPI 1053944850
  Medicare reassignment NPD

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

{
    "created_epoch": "1536451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1578046389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 BELMONT DR",
            "city": "CHELMSFORD",
            "state": "MA",
            "postal_code": "018244802",
            "telephone_number": "978-551-3448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 BELMONT DR",
            "city": "CHELMSFORD",
            "state": "MA",
            "postal_code": "018244802",
            "telephone_number": "978-551-3448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELLISSIMO",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-09",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "11668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MA LICENCE",
            "identifier": "11668",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@likeaphoenix.net",
            "affiliation": "Y",
            "endpointDescription": "Email",
            "affiliationName": "JEANOM LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Email",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "21 Cummings Park Ste 200",
            "city": "Woburn",
            "state": "MA",
            "country_code": "US",
            "postal_code": "018012198",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Vanessa Beaulieu
• Katherine Becker, OTR/L
• Behavior Blossoms ABA LLC
• Sydney Belanger
• Eugene Belle
• Sandra M Bello, LMT 4186
• Luke Bellone, DPT
• Joshua Craig Beltran
• Sherenity Benbow
• Cynthia Marie Berlied, P.T.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.