Active NPI
Jolene Jacquart, PHD
- Cognitive & Behavioral Psychologist
- Tucson, AZ
National Provider Identifier
1679237903
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cognitive & Behavioral Psychologist
- License
- 5349
- Practice address
- 3075 N Swan Rd Ste 206
Tucson, AZ 85712-1259 - Phone
- (520) 230-1065
- NPI assigned
- Oct 22, 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 |
|---|---|---|---|---|
| Cognitive & Behavioral Psychologist | 103TB0200X | 5349 | AZ | Primary |
Addresses
Primary practice location
3075 N Swan Rd Ste 206
Tucson, AZ 85712-1259
Mailing address
3075 N Swan Rd Ste 206
Tucson, AZ 85712-1259
Phone (520) 230-1065
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jan 6, 2023 through Jan 6, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5349 | AZ | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1634860800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697760000000",
"number": "1679237903",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3075 N SWAN RD STE 206",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857121259",
"telephone_number": "520-230-1065"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3075 N SWAN RD STE 206",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857121259",
"telephone_number": "520-230-1065"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACQUART",
"first_name": "JOLENE",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-10-22",
"last_updated": "2023-10-20",
"certification_date": "2023-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "AZ",
"license": "5349",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tucson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2023; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.