Jacqueline Hersh, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

5088 Issued in NC

Practice address

400 University Hall Drive
Boone, NC 28607-7660

Phone

(828) 262-6639

Fax

(828) 262-2974

NPI assigned

Nov 1, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Mar 20, 2026 through Mar 20, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Appalachian State University

  • Family Medicine Physician
  • Boone, NC
  • NPI 1376794255

  Clinical

  NPD (past)
• Appalachian State University

  • Community/Behavioral Health Agency
  • Boone, NC
  • NPI 1699104273
  NPD (past)

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

{
    "created_epoch": "1477958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785801600000",
    "number": "1982156386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 JOYCE LAWRENCE LN",
            "address_2": "ASU PSYCHOLOGY DEPARTMENT BOX 32109",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286082109",
            "telephone_number": "828-262-6969",
            "fax_number": "828-262-2974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 UNIVERSITY HALL DRIVE",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286077660",
            "telephone_number": "828-262-6639",
            "fax_number": "828-262-2974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERSH",
        "first_name": "JACQUELINE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-01",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "5088",
            "primary": true
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "NC",
            "license": "5088",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NC",
            "license": "5088",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tracie L Henson-Combs, FNP
• Brett Bailey Henson, D.C.
• Pamela A Henson, MS CCCSLP
• William Chadwick Henson, O.D.
• Grace Brinson Herman, MS, RD, LDN
• Lori Wilson Hiatt, OTR/L CHT
• Stephanie Gray Hickman, LCSW
• Caroline Grace Hicks, LCMHCA, LCASA
• Joan Marie Hicks, RN
• Sarah Armstrong Hicks, ATC, NASM-CES

• Clinical Psychologist in Boone, NC
• Providers in Boone, NC by specialty
• Clinical Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.