Jessica Brooke Virzi, PSY.D.
Individual provider Active NPI Clinical Psychologist · Ames, IA
NPI 1831547439 · NPPES record last updated May 25, 2016
Key facts
- NPI
- 1831547439
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 081009 (IA)
- Practice address
- 3401 Cullen Dr
Ames, IA 50010-1164 - Phone
- (440) 570-6910
- NPI assigned
- May 25, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Wright State University Boonshoft School of Medicine, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Capstone Behavioral Healthcare Inc
Practice addresses (Care Compare)
200 4TH Ave W
Grinnell, IA 50112-1833
Phone (641) 528-6065
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160816001156 | IA | Practitioner - Clinical Psychologist | 6507150471 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 081009 | IA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Capstone Behavioral Healthcare, Inc | Current |
Accepting new patients | |
| Poweshiek County Mental Health Center | Past | Accepting new patients |
Locations
200 4th Ave W
Grinnell, IA 50112
Phone (641) 236-6137
1123 1st Ave E
Ste 200
Newton, IA 50208
Phone (641) 792-4012
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 081009 | IA | Yes |
Addresses
Primary practice location
3401 Cullen Dr
Ames, IA 50010-1164
Mailing address
3401 Cullen Dr
Ames, IA 50010-1164
Other providers in Ames, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 25, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.