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

Last updated

Jan 8, 2013By the provider in NPPES

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

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• 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": [],
    "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.