Provider Demographics
NPI:1073958476
Name:BERENGUER, JESSICA E (PHD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:E
Last Name:BERENGUER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:JESSICA
Other - Middle Name:ELAINE
Other - Last Name:BARCLAY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:PO BOX 847
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38088-0847
Mailing Address - Country:US
Mailing Address - Phone:615-784-8142
Mailing Address - Fax:615-691-7140
Practice Address - Street 1:ENCOMPASS HEALTH REHABILITATION HOSPITAL OF FRANKLIN
Practice Address - Street 2:1000 PHYSICIANS WAY, OUTPATIENT OFFICES
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067
Practice Address - Country:US
Practice Address - Phone:615-784-8142
Practice Address - Fax:615-691-7140
Is Sole Proprietor?:No
Enumeration Date:2013-04-30
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019887103G00000X
DC1000902103G00000X
TN3148103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ002234Medicaid
TN103I683091OtherMEDICARE INDIVIDUAL PROVIDER PTAN