Jessica Ann Holcomb, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2994 Issued in OR

Practice address

880 82ND Dr
Gladstone, OR 97027-1803

Phone

(903) 445-4424

NPI assigned

Aug 23, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Western Psychological and Counseling Services LLCGroup PAC ID 7719975085, 331 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lifestancehealth.jessicaholcomb@148835.advancedmd-direct.com

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.

• Western Psychological and Counseling Services LLC

  dba LifeStance Health

  • Clinical Psychologist
  • Tacoma, WA
  • NPI 1912008178

  OR

  Medicare reassignment Care Compare group NPD
• Western Psychological and Counseling Services LLC

  dba LifeStance Health

  • Clinical Psychologist
  • Vancouver, WA
  • NPI 1629345731
  NPD

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

{
    "created_epoch": "1534982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1962983403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15519 SE BADEN POWELL RD",
            "city": "HAPPY VALLEY",
            "state": "OR",
            "postal_code": "970866049",
            "telephone_number": "903-445-4424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 82ND DR",
            "city": "GLADSTONE",
            "state": "OR",
            "postal_code": "970271803",
            "telephone_number": "903-445-4424"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12636 SE Stark St Bldg J",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972331058",
            "country_code": "US",
            "telephone_number": "903-445-4424",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2222 E Powell Blvd",
            "address_purpose": "LOCATION",
            "city": "Gresham",
            "state": "OR",
            "postal_code": "970801365",
            "country_code": "US",
            "telephone_number": "903-445-4424",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "870 82nd Dr",
            "address_purpose": "LOCATION",
            "city": "Gladstone",
            "state": "OR",
            "postal_code": "970271803",
            "country_code": "US",
            "telephone_number": "903-445-4424",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "890 82nd Dr",
            "address_purpose": "LOCATION",
            "city": "Gladstone",
            "state": "OR",
            "postal_code": "970271803",
            "country_code": "US",
            "telephone_number": "903-445-4424",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLCOMB",
        "first_name": "JESSICA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-23",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "2994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sean Scott Harper, M.D.
• Daniel Hazen
• Teresa Heesacker, MA
• Dennis W Henderson, PSY.D.
• Cathleen E Hite-Godeck
• Honeymint Pediatric Dentistry - Gladstone
• Jane E. Huey, LCSW
• Teresa Hunt, LPC
• Tonya Kay Inman, FNP
• Iron Tribe Network

• Clinical Psychologist in Gladstone, OR
• Providers in Gladstone, OR by specialty
• Clinical Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.