Individual provider Active NPI

Jane Stafford, PH.D.

  • Psychologist
  • Aiken, SC
National Provider Identifier
1730456740
Registry record updated Nov 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1008 Issued in SC
Practice address
33 Varden Dr
Aiken, SC 29803-5285
Phone
(803) 642-3801
NPI assigned
Nov 18, 2011
Last updated
Nov 18, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1008 SC Primary

Addresses

Primary practice location

33 Varden Dr
Aiken, SC 29803-5285

Mailing address

33 Varden Dr
Aiken, SC 29803-5285
Phone (803) 642-3801

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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

Enrollment IDStateProvider typePAC IDDetails
I20131108000665 SC Practitioner - Clinical Psychologist 8527293059 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1008SCMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Aiken Psychiatric and Psychotherapy Associates PA CurrentSince Aug 12, 2013 Accepting new patients
Neighborhood Improvement Project Inc CurrentSince Jan 1, 2025 Accepting new patients
Neighborhood Improvement Project Inc CurrentSince Jan 1, 2025 Accepting new patients
Aiken Psychotherapy Past Accepting new patients

Locations

2467 Golden Camp Rd
Augusta, GA 30906
Phone (706) 922-0682

33 Varden Dr
Aiken, SC 29803
Phone (803) 642-3801

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1321574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321574400000",
    "number": "1730456740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 VARDEN DR",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298035285",
            "telephone_number": "803-642-3801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 VARDEN DR",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298035285",
            "telephone_number": "803-642-3801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAFFORD",
        "first_name": "JANE",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-18",
        "last_updated": "2011-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "SC",
            "license": "1008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aiken, SC

Sources for this page

Verify at the official NPI Registry.