Jennifer Christa Willoughby, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

03600 Issued in MD

Practice address

41900 Fenwick St
Suite #1
Leonardtown, MD 20650-3814

Phone

(301) 475-9660

Fax

(301) 475-8810

NPI assigned

Aug 21, 2006

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 10

Medicare fee-for-service enrollment

Enrolled in MD

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, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Hope and Healing Psychotherapy LLCGroup PAC ID 9638515315, 8 clinicians

Psychological Services Center, LLCGroup PAC ID 3971544289, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Psychological Services Center, LLC

  • Counselor
  • Leonardtown, MD
  • NPI 1215043666
  Medicare reassignment Care Compare group NPD Authorized official
• Hope and Healing Psychotherapy, LLC

  • Clinical Social Worker
  • Leonardtown, MD
  • NPI 1225593361
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357603200000",
    "number": "1619083110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1608",
            "city": "LEONARDTOWN",
            "state": "MD",
            "postal_code": "206501608",
            "telephone_number": "301-475-9660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41900 FENWICK ST",
            "address_2": "SUITE #1",
            "city": "LEONARDTOWN",
            "state": "MD",
            "postal_code": "206503814",
            "telephone_number": "301-475-9660",
            "fax_number": "301-475-8810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLOUGHBY",
        "first_name": "JENNIFER",
        "middle_name": "CHRISTA",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2013-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MD",
            "license": "03600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDIPA",
            "identifier": "379528",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7729469",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS FEP & NCA",
            "identifier": "B950 0007",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "262293000",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALLIANCE",
            "identifier": "379528",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APS",
            "identifier": "PVPB114888",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEHA",
            "identifier": "379528",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "379528",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS",
            "identifier": "517B 60718903",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMUM CHOICE",
            "identifier": "379528",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Randall E Wiley, DC, MSN, ARNP
• Kelly Lynn Willer, MOTR/L
• Alyssa Susan Williams, PMHNP-BC
• April D Williams, RRA
• Margaret Harsany Williams, PT
• Kristen Elizabeth Wilson, LCSW-C
• Tiffany Wilson, CRNP
• Samantha Pauline Wilt, MS, CCC-SLP
• Erica Audrey Winter, PA-C
• Karin Elisabeth Witte, M.D.

• Psychologist in Leonardtown, MD
• Providers in Leonardtown, MD by specialty
• Psychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2013; 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.