Active NPI
Jessica Stephanie Boisrond-Canal, M.S.
- School Psychologist
- Forest Hills, NY
National Provider Identifier
1649847005
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 1495553211
- Practice address
- 7000 Austin St
Forest Hills, NY 11375-1022 - Phone
- (718) 762-7633
- NPI assigned
- Jun 4, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 1495553211 | NY | Primary |
Addresses
Primary practice location
7000 Austin St
Forest Hills, NY 11375-1022
Mailing address
152 Weeks Dr
Dix Hills, NY 11746-6216
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1495553211 | NY | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1622764800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623456000000",
"number": "1649847005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "152 WEEKS DR",
"city": "DIX HILLS",
"state": "NY",
"postal_code": "117466216"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7000 AUSTIN ST",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "113751022",
"telephone_number": "718-762-7633"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOISROND-CANAL",
"first_name": "JESSICA STEPHANIE",
"credential": "M.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-06-04",
"last_updated": "2021-06-12",
"certification_date": "2021-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "NY",
"license": "1495553211",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Forest Hills, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.