Joseph J. Peters Institute

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

117040 Issued in PA

Legal business name

JOSEPH J. PETERS INSTITUTE

Practice address

100 South Broad Street
17TH Floor
Philadelphia, PA 19110

Phone

(215) 701-1560

Fax

(215) 701-1572

NPI assigned

Dec 6, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Ivan O Haskell, PH.D.NPI 1245369131

Title

Executive Director

Phone

(215) 701-1560

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Adela Scharff, PHD

  • Psychologist
  • Philadelphia, PA
  • NPI 1609749944
  Medicare reassignment NPD
• Ivan Haskell

  • Psychologist
  • Philadelphia, PA
  • NPI 1245369131
  NPD Authorized official
• Catherine Verdeur, PSY.D.

  • Psychologist
  • Willow Grove, PA
  • NPI 1073731725
  Medicare reassignment
• Theodore E Glackman, M.ED.

  • Psychologist
  • Philadelphia, PA
  • NPI 1447497854
  NPD (past)
• Joanne Mary Minerva, M.D.

  • Specialist
  • Philadelphia, PA
  • NPI 1538384524
  NPD (past)
• Kelly Ann Nabal, PSY.D.

  • Clinical Psychologist
  • Philadelphia, PA
  • NPI 1356639603
  NPD (past)
• James Monroe Pedigo, MD

  • Psychiatry Physician
  • Villanova, PA
  • NPI 1891887444
  NPD (past)
• Jessica Lynn Zimmerman, M.D.

  • Child & Adolescent Psychiatry Physician
  • Philadelphia, PA
  • NPI 1053538322
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740355200000",
    "number": "1023177144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SOUTH BROAD STREET",
            "address_2": "17TH FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19110",
            "telephone_number": "215-701-1560",
            "fax_number": "215-701-1572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SOUTH BROAD STREET",
            "address_2": "17TH FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19110",
            "telephone_number": "215-701-1560",
            "fax_number": "215-701-1572"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2300 W Master St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191214996",
            "country_code": "US",
            "telephone_number": "445-289-0398",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 S Broad St Ste 1525",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191101026",
            "country_code": "US",
            "telephone_number": "215-701-1560",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1100 Devereaux Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191115826",
            "country_code": "US",
            "telephone_number": "267-279-3993",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4601 Market St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191394636",
            "country_code": "US",
            "telephone_number": "215-764-2387",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1211 Chestnut St Fl 5",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191074117",
            "country_code": "US",
            "telephone_number": "215-665-8670",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JOSEPH J. PETERS INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A",
        "authorized_official_last_name": "HASKELL",
        "authorized_official_first_name": "IVAN",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "215-701-1560",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "PA",
            "license": "117040",
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007562120008",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joel Jose, PHARM D
• Keritza Joseph Brown
• Joseph H Calhoun MD PC
• Joseph H Hylinski DPM
• Joseph J Williams MD PC
• Joseph L Borkson MD PC
• Joseph Lutz DMD (Lutz Family Dentistry)
• Joseph M Lichtman, MD PC
• Joseph M. Brogan D.M.D PC
• Joseph M. Hogan, M.D., Associates

• Community/Behavioral Health Agency in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Community/Behavioral Health Agency in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.