Active NPI
Jessica A Stephan
- School Psychologist
- Brick, NJ
National Provider Identifier
1851038269
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 913778
- Practice address
- 2557 Hooper Ave
Brick, NJ 08723-6238 - Phone
- (732) 701-3711
- NPI assigned
- May 17, 2022
- 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 |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 913778 | NJ | Primary |
Addresses
Primary practice location
2557 Hooper Ave
Brick, NJ 08723-6238
Mailing address
54 Estate Point Rd
Toms River, NJ 08753-2046
Phone (732) 966-1399
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 |
|---|---|---|---|
| 913778 | NJ | MD | School Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Professional Therapy Associates | 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.
-
- Pediatric Occupational Therapist
- Brick, NJ
- NPI 1740556067
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1652745600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655769600000",
"number": "1851038269",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "54 ESTATE POINT RD",
"city": "TOMS RIVER",
"state": "NJ",
"postal_code": "087532046",
"telephone_number": "732-966-1399"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2557 HOOPER AVE",
"city": "BRICK",
"state": "NJ",
"postal_code": "087236238",
"telephone_number": "732-701-3711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEPHAN",
"first_name": "JESSICA",
"middle_name": "A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-05-17",
"last_updated": "2022-06-21",
"certification_date": "2022-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "NJ",
"license": "913778",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brick, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 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.