JESSICA EDEN MANDELL PHD
NPI 1376289629
Psychologist in Charlotte, NC

Active since May 10, 2022Opted out of Medicare · through Feb 18, 2027
1515 MOCKINGBIRD LN STE 580, CHARLOTTE, NC 28209(704) 910-8381(704) 981-8282 Get Directions Write a Review

NPPES record last updated: April 4, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Apr 4, 2025, Aug 14, 2024, May 10, 2022 (3 updates tracked since 2022).

About Jessica Eden Mandell Phd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JESSICA EDEN MANDELL PHD (NPI 1376289629) is an individual psychologist in Charlotte, North Carolina, licensed in North Carolina (6743) and active in the NPI registry since May 2022. She has opted out of Medicare through February 18, 2027.

NPPES Registry Identity

NPI1376289629
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameJESSICA EDEN MANDELLCredential: PHD
Location Address1515 MOCKINGBIRD LN STE 580Charlotte, NC 28209-1171
Mailing Address1515 Mockingbird Ln Ste 580Charlotte, NC 28209-1171 · (704) 910-8381 · Fax (704) 981-8282
Fax(704) 981-8282
Sole ProprietorNo
Enumeration DateMay 10, 2022
Last NPPES UpdateApril 4, 20253 updates tracked since enumeration
NPPES CertifiedApril 4, 2025
NPI 1376289629 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in NC · 6743
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
1515 MOCKINGBIRD LN STE 580, Charlotte, NC 28209

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Jessica Eden Mandell Phd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from February 18, 2025 through February 18, 2027.

Opt-Out Effective DateFebruary 18, 2025
Opt-Out In Effect ThroughFebruary 18, 2027Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Counselor (Mental Health)
1515 MOCKINGBIRD LN STE 580
CHARLOTTE, NC 28209
Psychologist
1515 MOCKINGBIRD LN STE 580
CHARLOTTE, NC 28209
Psychologist
1515 MOCKINGBIRD LN STE 580
CHARLOTTE, NC 28209
Psychologist
1515 MOCKINGBIRD LN STE 580
CHARLOTTE, NC 28209
Psychologist
1515 MOCKINGBIRD LN STE 580
CHARLOTTE, NC 28209
Psychologist
1515 MOCKINGBIRD LN STE 580
CHARLOTTE, NC 28209
Psychologist
1515 MOCKINGBIRD LN STE 580
CHARLOTTE, NC 28209
Psychologist
1515 MOCKINGBIRD LN STE 580
CHARLOTTE, NC 28209

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jessica Mandell's NPI number?

The NPI number for Jessica Mandell is 1376289629. It was assigned to this individual provider in the NPPES registry on May 10, 2022.

Where is Jessica Mandell located?

Jessica Mandell practices at 1515 Mockingbird Ln Ste 580, Charlotte, NC 28209. The listed phone number is (704) 910-8381.

What is Jessica Mandell's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Jessica Mandell enrolled in Medicare?

No. Jessica Mandell has opted out of Medicare through February 18, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Jessica Mandell was last updated on April 4, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.