Individual provider Active NPI

Jessica Hasson

  • Clinical Psychologist
  • Rockville, MD
National Provider Identifier
1942678883
Registry record updated Jan 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
04976 Issued in MD
Practice address
9707 Key West Ave Ste 100
Rockville, MD 20850-3992
Phone
(240) 750-6467
NPI assigned
Sep 9, 2015
Last updated
Jan 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X
Clinical Psychologist 103TC0700X 1000570 DC
Clinical Psychologist 103TC0700X 0810004181 VA
Clinical Psychologist 103TC0700X 04976 MD Primary

Addresses

Primary practice location

9707 Key West Ave Ste 100
Rockville, MD 20850-3992

Mailing address

12501 Fostoria Way
Gaithersburg, MD 20878-2235

Other practice location 1

12501 Fostoria Way
Gaithersburg, MD 20878-2235
Phone (240) 813-8545

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: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1000570DCMDClinical Psychologist
04976MDMDClinical Psychologist
0810004181VAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Pay It Forward Assessments, LLC Clinical CurrentSince Feb 11, 2024 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, 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": "1441756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1942678883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12501 FOSTORIA WAY",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208782235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9707 KEY WEST AVE STE 100",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503992",
            "telephone_number": "240-750-6467"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12501 Fostoria Way",
            "address_purpose": "LOCATION",
            "city": "Gaithersburg",
            "state": "MD",
            "postal_code": "208782235",
            "country_code": "US",
            "telephone_number": "240-813-8545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HASSON",
        "first_name": "JESSICA",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-09",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "DC",
            "license": "1000570",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810004181",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "04976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

Verify at the official NPI Registry.