Jacquelyn Avery, PHD
NPI 1952705170ActiveIndividual· Psychologist, Clinical· Minneapolis, MN
Psychologist, Clinical (PHD) in Minneapolis, Minnesota, trained at Washington University School of Medicine (class of 2002).
Overview
| NPI | 1952705170 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PHD |
| Sole proprietor | No |
| NPI issued | Oct 17, 2014 |
| Last updated in NPPES | Jun 24, 2019 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, Clinical Primary | 103TC0700X | LP5877 | MN |
| Psychologist, Clinical | 103TC0700X | 6301014810 | MI |
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) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Education and affiliations
| Medical school | Washington University School of Medicine |
|---|---|
| Graduation year | 2002 |
| Medicare specialty | Clinical Psychologist |
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