Active NPI
Jody Stevenson Summers, PSY.D.
- Clinical Psychologist
- Lexington, SC
National Provider Identifier
1760616213
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1085
- Practice address
- 704 Bentley Dr
Lexington, SC 29072-7500 - Phone
- (803) 606-6678
- NPI assigned
- May 13, 2009
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1085 | SC | Primary |
Addresses
Primary practice location
704 Bentley Dr
Lexington, SC 29072-7500
Mailing address
704 Bentley Dr
Lexington, SC 29072-7500
Phone (803) 606-6678
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1085 | SC | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1242172800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711324800000",
"number": "1760616213",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "704 BENTLEY DR",
"city": "LEXINGTON",
"state": "SC",
"postal_code": "290727500",
"telephone_number": "803-606-6678"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "704 BENTLEY DR",
"city": "LEXINGTON",
"state": "SC",
"postal_code": "290727500",
"telephone_number": "803-606-6678"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUMMERS",
"first_name": "JODY",
"middle_name": "STEVENSON",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-05-13",
"last_updated": "2024-03-25",
"certification_date": "2024-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "SC",
"license": "1085",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lexington, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.