JESSICA DANIELLE BIREN CAVERLY, Ph.D. — NPI 1184873721 (Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Clinical in BROOKFIELD, CT)

CMS-1500 Box 24J / 33a • NPI

1184873721

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

103TC0700X (CMS 62)

Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Clinical

Box 32 Service Location & ZIP+4

2 OLD NEW MILFORD RD, 1E, BROOKFIELD, CT, 06804-2426

✓ 9-Digit EDI 837 ZIP+4 (06804-2426)

Practice Phone & Referral Fax

(203) 885-0500

Fax: (203) 702-5345

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1184873721 (JESSICA DANIELLE BIREN CAVERLY, Ph.D.) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1184873721` (NPI-1 Individual Practitioner)
Provider / Legal Name	JESSICA DANIELLE BIREN CAVERLY, Ph.D.
Plain-English Specialty	Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Clinical NUCC Code: `103TC0700X` (Psychologist, Clinical)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	2 OLD NEW MILFORD RD, 1E, BROOKFIELD, CT, 06804-2426
Practice Telephone / Fax	Tel: (203) 885-0500 \| Fax: (203) 702-5345
Administrative Mailing Address	2 OLD NEW MILFORD RD, BROOKFIELD, CT, 06804-2647
Enumeration & Last Sync	Enumerated: 2008-09-18 \| CMS Record Updated: 2014-10-05

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

2 OLD NEW MILFORD RD, 1E, BROOKFIELD, CT, 06804-2426

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Plain-English Taxonomy & CMS Crosswalk (103TC0700X)

What Does Taxonomy Code 103TC0700X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 103TC0700X translates to:
"Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Clinical"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 62 (Psychologist, Clinical) • CMS Code 68 (Psychologist, Clinical)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Psychologist, Clinical for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (JESSICA DANIELLE BIREN CAVERLY, Ph.D.)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`103TC0700X` — Psychologist, Clinical Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Clinical	State: MA \| License: `9367` \| Primary: Yes (Primary)
`103G00000X` — Clinical Neuropsychologist Plain English: Licensed & Credentialed Clinical Neuropsychologist	State: CT \| License: `3248` \| Primary: Secondary
`103T00000X` — Psychologist Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist	State: CT \| License: `3248` \| Primary: Secondary
`103TC0700X` — Psychologist, Clinical Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Clinical	State: CT \| License: `3248` \| Primary: Secondary
`103TC2200X` — Psychologist, Clinical Child & Adolescent Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Clinical Child & Adolescent	State: CT \| License: `3248` \| Primary: Secondary
`103TB0200X` — Psychologist, Cognitive & Behavioral Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Cognitive & Behavioral	State: CT \| License: `3248` \| Primary: Secondary
`103TF0200X` — Psychologist, Forensic Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Forensic	State: CT \| License: `3248` \| Primary: Secondary
`103TM1800X` — Psychologist, Intellectual & Developmental Disabilities Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Intellectual & Developmental Disabilities	State: CT \| License: `3248` \| Primary: Secondary
`103TH0004X` — Psychologist, Health Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Health	State: CT \| License: `3248` \| Primary: Secondary

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JESSICA DANIELLE BIREN CAVERLY, Ph.D. (NPI #1184873721)