Individual provider Active NPI

Jennifer Bridges Daniels, PH.D.

  • Clinical Psychologist
  • Auburn, AL
National Provider Identifier
1841424512
Registry record updated Apr 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1548 Issued in AL
Practice address
861 N Dean Rd Ste D
Auburn, AL 36830-9421
Phone
(334) 887-4343
Fax
(334) 887-5656
NPI assigned
May 11, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1548 AL Primary

Addresses

Primary practice location

861 N Dean Rd Ste D
Auburn, AL 36830-9421

Mailing address

861 N Dean Rd Ste D
Auburn, AL 36830-9421
Phone (334) 887-4343

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jun 19, 2019 through Jun 19, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1548ALMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Auburn Psychology Group, LLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1242000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333411200000",
    "number": "1841424512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "861 N DEAN RD STE D",
            "city": "AUBURN",
            "state": "AL",
            "postal_code": "368309421",
            "telephone_number": "334-887-4343",
            "fax_number": "334-887-5656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "861 N DEAN RD STE D",
            "city": "AUBURN",
            "state": "AL",
            "postal_code": "368309421",
            "telephone_number": "334-887-4343",
            "fax_number": "334-887-5656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIELS",
        "first_name": "JENNIFER",
        "middle_name": "BRIDGES",
        "name_prefix": "Mrs.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-11",
        "last_updated": "2012-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AL",
            "license": "1548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, AL

Sources for this page

Verify at the official NPI Registry.