NPIMap

Organization Active NPI

Jessica C Effrig Psychotherapy LLC

  • Community/Behavioral Health Agency
  • State College, PA
National Provider Identifier
1740703636
Registry record updated Mar 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
JESSICA C EFFRIG PSYCHOTHERAPY LLC
Practice address
141 E Fairmount Ave
State College, PA 16801-5315
Phone
(814) 234-3464
NPI assigned
Jul 21, 2017
Last updated
Mar 6, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2023

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

Authorized official

Name
Dr. Jessica Crysten Effrig, PH.D.NPI 1588057509
Title
Owner/Licensed Psychologist
Phone
(814) 954-2448

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

141 E Fairmount Ave
State College, PA 16801-5315

Mailing address

141 E Fairmount Ave
State College, PA 16801-5315
Phone (814) 234-3464

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240725000377 PA Part B Supplier - Clinic/Group Practice 7810433992 Receives reassigned benefits from 1 practitioner
Practice locations: State College, PA

National Provider Directory

National Provider Directory

Locations

301 S Allen St
Ste 103A
State College, PA 16801
Phone (757) 793-8325

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1500595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678060800000",
    "number": "1740703636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 E FAIRMOUNT AVE",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168015315",
            "telephone_number": "814-234-3464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 E FAIRMOUNT AVE",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168015315",
            "telephone_number": "814-234-3464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JESSICA C EFFRIG PSYCHOTHERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-21",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A",
        "authorized_official_last_name": "EFFRIG",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "CRYSTEN",
        "authorized_official_title_or_position": "OWNER/LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "814-954-2448",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in State College, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.