Jacqueline Alexandra Anderson, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY5982 Issued in FL

Practice address

2801 SW College Rd Ste 3
Ocala, FL 34474-4430

Phone

(352) 804-2875

Fax

(352) 390-3868

NPI assigned

Feb 3, 2008

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network

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.

• Psychological Services & Consultations, LLC

  • Clinical Psychologist
  • Ocala, FL
  • NPI 1770967309
  NPD
• University of Miami

  • Psychiatry Physician
  • Miami, FL
  • NPI 1437109048
  NPD (past)

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

{
    "created_epoch": "1201996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697932800000",
    "number": "1700064664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 772345",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344772345",
            "telephone_number": "786-246-0656",
            "fax_number": "325-390-3868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 SW COLLEGE RD STE 3",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344744430",
            "telephone_number": "352-804-2875",
            "fax_number": "352-390-3868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JACQUELINE",
        "middle_name": "ALEXANDRA",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-03",
        "last_updated": "2023-10-22",
        "certification_date": "2023-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY5982",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY5982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anchored in Breaking Barriers LLC
• Bridget Anderson, ARNP
• Cashesha Anderson
• Danette A Anderson, APRN
• David Anderson, DO
• Julie Nickoy Anderson
• Kaelee Mae Anderson, RBT
• Lauren Anderson, M.A., CCC/SLP
• Norman H Anderson, M.D.
• Paul Edward Anderson, O.D.

• Clinical Psychologist in Ocala, FL
• Providers in Ocala, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.