Individual provider Active NPI

Jessica Paola Pfeiffer, LCSW

  • Clinical Psychologist
  • Ames, IA
National Provider Identifier
1912215666
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
129562 Issued in IA
Practice address
2028 Ashmore Dr
Ames, IA 50014-7805
Phone
(515) 460-4446
NPI assigned
Sep 15, 2010
Last updated
Dec 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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 129562 IA Primary
Clinical Social Worker 1041C0700X CSW00001400 CO
Clinical Social Worker 1041C0700X 129225 IA

Addresses

Primary practice location

2028 Ashmore Dr
Ames, IA 50014-7805

Mailing address

2028 Ashmore Dr
Ames, IA 50014-7805
Phone (515) 460-4446

Other identifiers 1

IdentifierTypeStateIssuer
9000196597MedicaidCO

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
129562IAMDClinical Psychologist
CSW00001400COMDClinical Social Worker
129225IAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Intricate Roots, LLC Clinical CurrentSince Oct 1, 2021 Accepting new patients
Ames Counseling and Psychological Services PC Clinical Past Accepting new patients
Court House Inc. Past Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1284508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1912215666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2028 ASHMORE DR",
            "city": "AMES",
            "state": "IA",
            "postal_code": "500147805",
            "telephone_number": "515-460-4446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2028 ASHMORE DR",
            "city": "AMES",
            "state": "IA",
            "postal_code": "500147805",
            "telephone_number": "515-460-4446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PFEIFFER",
        "first_name": "JESSICA",
        "middle_name": "PAOLA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-15",
        "last_updated": "2024-12-04",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IA",
            "license": "129562",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW00001400",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "129225",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000196597",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ames, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 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.

Verify at the official NPI Registry.