Individual provider Active NPI

Jolene Trimm, M.S. ED

  • School Psychologist
  • Brooklyn, NY
National Provider Identifier
1972865558
Registry record updated Jun 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
433163101 Issued in NY
Practice address
2625 E 14TH St Ste 200
Brooklyn, NY 11235-3973
Phone
(718) 769-2698
NPI assigned
Jun 11, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X 433163101 NY Primary

Addresses

Primary practice location

2625 E 14TH St Ste 200
Brooklyn, NY 11235-3973

Mailing address

416 Rockaway Pkwy Apt 3a
Brooklyn, NY 11212-3334
Phone (718) 938-2194

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
433163101NYMDSchool Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1339372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339372800000",
    "number": "1972865558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 ROCKAWAY PKWY APT 3A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112123334",
            "telephone_number": "718-938-2194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 E 14TH ST STE 200",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112353973",
            "telephone_number": "718-769-2698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIMM",
        "first_name": "JOLENE",
        "name_prefix": "Ms.",
        "credential": "M.S. ED",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-11",
        "last_updated": "2012-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "NY",
            "license": "433163101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2012; 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.