Jodi Allison Brin, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

3346-57 Issued in WI

Practice address

14135 N Cedarburg Rd
Mequon, WI 53097-1416

Phone

(262) 377-2006

NPI assigned

May 24, 2016

Last updated

May 24, 2016By 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

Other names 1

• Jodi Allison Green Former name

Medicare fee-for-service enrollment

Enrolled in WI

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, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

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

• Jodi Brin Psychological Services LLC

  • Clinical Psychologist
  • Mequon, WI
  • NPI 1134577133
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1464048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464048000000",
    "number": "1629426200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14135 N CEDARBURG RD",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530971416",
            "telephone_number": "262-377-2006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14135 N CEDARBURG RD",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530971416",
            "telephone_number": "262-377-2006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIN",
        "first_name": "JODI",
        "middle_name": "ALLISON",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-24",
        "last_updated": "2016-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "3346-57",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JODI",
            "last_name": "GREEN",
            "middle_name": "ALLISON",
            "credential": "PSY.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brent J Martin DDS Ms SC
• Brett Egelseer (Advanced Spine Center)
• Brewer Counseling and Wellness
• Cameron Craig Brewer, PH.D.
• Brian M. Fidlin Psychological Services
• John Scott Broderick, M.D.
• Benjamin Broghammer, M.D.
• Katrina Marie Brown, MS.ED., LPC
• Keely Bornor Browning
• Leah M Bruce, LPC, SAC

• Clinical Psychologist in Mequon, WI
• Providers in Mequon, WI by specialty
• Clinical Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2016; 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.