Active NPI
Jessica Alyce Stembel, PSY.D., HSPP
- Clinical Psychologist
- Indianapolis, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 20042096A
- Practice address
- 8320 Madison Ave
Indianapolis, IN 46227-6066 - Phone
- (317) 494-0739
- NPI assigned
- Dec 4, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist | 103TC2200X | 20042096 | IN | |
| Clinical Psychologist | 103TC0700X | 20042096A | IN | Primary |
Addresses
Primary practice location
8320 Madison Ave
Indianapolis, IN 46227-6066
Mailing address
8320 Madison Ave
Indianapolis, IN 46227-6066
Phone (317) 494-0739
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200845530 | Medicaid | IN |
Other names 1
- Jessica Alyce Bissey
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20042096A | IN | MD | Clinical Psychologist |
Interoperability endpoints
- jessica.bissey.p1@direct.adultandchild.nextgenshare.com
Ownership & related parties
All facility ownership & control disclosures 5
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Adult and Child Mental Health Center | Federally qualified health center | Corporate Officer Corporate Director W-2 Managing Employee Operational/Managerial Control |
Sep 18, 2024 Sep 18, 2024 Sep 18, 2024 Sep 18, 2024 |
| Adult and Child Community Medical Services | Federally qualified health center | Corporate Officer Corporate Director W-2 Managing Employee Operational/Managerial Control |
Sep 18, 2024 Sep 18, 2024 Sep 18, 2024 Sep 18, 2024 |
| Adult and Child Health | Federally qualified health center | Corporate Officer Corporate Director W-2 Managing Employee Operational/Managerial Control |
Sep 18, 2024 Sep 18, 2024 Sep 18, 2024 Sep 18, 2024 |
| Adult and Child Health - Neighborhood Clinic | Federally qualified health center | Corporate Officer Corporate Director W-2 Managing Employee Operational/Managerial Control |
Sep 18, 2024 Sep 18, 2024 Sep 18, 2024 Sep 18, 2024 |
| Adult and Child -Siear Terrace | Federally qualified health center | Corporate Officer Corporate Director W-2 Managing Employee Operational/Managerial Control |
Sep 18, 2024 Sep 18, 2024 Sep 18, 2024 Sep 18, 2024 |
Owned or controlled facilities with NPI records 1
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
- Federally Qualified Health Center (FQHC)
- Indianapolis, IN
- NPI 1538514344
Corporate Director, Corporate Officer, Operational/Managerial Control, W-2 Managing Employee
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.
-
- Community/Behavioral Health Agency
- Indianapolis, IN
- NPI 1154368512
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685577600000",
"number": "1659439628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8320 MADISON AVE",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462276066",
"telephone_number": "317-494-0739"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8320 MADISON AVE",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462276066",
"telephone_number": "317-494-0739"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEMBEL",
"first_name": "JESSICA",
"middle_name": "ALYCE",
"name_prefix": "Dr.",
"credential": "PSY.D., HSPP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-04",
"last_updated": "2023-06-01",
"certification_date": "2023-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "IN",
"license": "20042096",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IN",
"license": "20042096A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200845530",
"state": "IN"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JESSICA",
"last_name": "BISSEY",
"middle_name": "ALYCE",
"credential": "PSYD",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.