MEDICARE: DR. JESSICA THORPE EDDINS PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	PSY1001190	DC
2	103T00000X	Psychologist	05784	MD
3	103T00000X	Psychologist	0810007419	VA

General Provider Information

NPI Number	:	1265147037
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JESSICA THORPE EDDINS PSY.D.

Provider Business Mailing Address
First Line	:	712 H ST NE UNIT 823
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20002-3627
Country	:	US
Telephone Number	:	202-417-8929
Fax Number	:

Provider Business Practice Location Address
First Line	:	611 D ST SE UNIT 1
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20003-2099
Country	:	US
Telephone Number	:	202-417-8929
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/17/2023
Last Update Date	:	01/17/2023

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