Individual provider Active NPI

Jennifer Lee Christofferson, PHD

  • Clinical Child & Adolescent Psychologist
  • Brookline, MA
National Provider Identifier
1609768233
Registry record updated Sep 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
PSY10001926 Issued in MA
Practice address
2 Brookline PL
Brookline, MA 02445-7230
Phone
(617) 355-6680
NPI assigned
Jul 17, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X PSY10001926 MA Primary
Health Service Psychologist 103TH0100X

Addresses

Primary practice location

2 Brookline PL
Brookline, MA 02445-7230

Mailing address

2 Brookline PL
Brookline, MA 02445-7230
Phone (617) 355-6680

Other practice location 1

300 Longwood Ave
Boston, MA 02115-5724
Phone (617) 355-6000

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20251006001746 MA Practitioner - Clinical Psychologist 0345746590 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

300 Longwood Ave
Boston, MA 02115-5737

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY10001926MAMDClinical Child & Adolescent Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
CHMC Anesthesia Foundation Inc Clinical Child & Adolescent CurrentSince Oct 6, 2025 Accepting new patients

Locations

300 Longwood Ave
Boston, MA 02115
Phone (617) 355-4956

2 Brookline Pl
Brookline, MA 02445
Phone (617) 355-2727

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": "1752710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758844800000",
    "number": "1609768233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 BROOKLINE PL",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024457230",
            "telephone_number": "617-355-6680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 BROOKLINE PL",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024457230",
            "telephone_number": "617-355-6680"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Longwood Ave",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021155724",
            "country_code": "US",
            "telephone_number": "617-355-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHRISTOFFERSON",
        "first_name": "JENNIFER",
        "middle_name": "LEE",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-17",
        "last_updated": "2025-09-26",
        "certification_date": "2025-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MA",
            "license": "PSY10001926",
            "primary": true
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

Verify at the official NPI Registry.