Jill Marie Brenneman, PHD
NPI 1619645157ActiveIndividual· Psychologist, Clinical Child & Adolescent· Worthington, OH
Psychologist, Clinical Child & Adolescent (PHD) in Worthington, Ohio, trained at Ohio State University College of Medicine (class of 2021). Enrolled in Medicare as practitioner - clinical psychologist.
Overview
| NPI | 1619645157 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PHD |
| Sole proprietor | No |
| NPI issued | Aug 31, 2021 |
| Last updated in NPPES | Dec 13, 2024 |
| Certified by provider | Dec 13, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, Clinical Child & Adolescent Primary | 103TC2200X | P.08713 | OH |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Psychologist (OH) |
|---|
Education and affiliations
| Medical school | Ohio State University College of Medicine |
|---|---|
| Graduation year | 2021 |
| Medicare specialty | Clinical Psychologist |
Medical group
- I Am Boundless IncWorthington, OH · 17 clinicians
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