Individual provider Active NPI

Michelle Katz Jesop, PSY.D.

  • Clinical Psychologist
  • Brentwood, TN
National Provider Identifier
1790106193
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY.0003961 Issued in CO
Practice address
9005 Overlook Blvd Ste 117
Brentwood, TN 37027-5269
Phone
(615) 719-2392
NPI assigned
Jan 2, 2014
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X P0000003446 TN
Clinical Psychologist 103TC0700X PY00003666 WA
Clinical Psychologist 103TC0700X PSY.0003961 CO Primary

Addresses

Primary practice location

9005 Overlook Blvd Ste 117
Brentwood, TN 37027-5269

Mailing address

9005 Overlook Blvd Ste 117
Brentwood, TN 37027-5269
Phone (615) 719-2392

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

LicenseStateTypeSpecialty
PSY.0003961COMDClinical Psychologist
P0000003446TNMDClinical Psychologist
PY00003666WAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1388620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1790106193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9005 OVERLOOK BLVD STE 117",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275269",
            "telephone_number": "615-719-2392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9005 OVERLOOK BLVD STE 117",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275269",
            "telephone_number": "615-719-2392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATZ JESOP",
        "first_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-02",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "P0000003446",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY00003666",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "PSY.0003961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.