Jennifer Tickal, Psy.D., P.a.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY8723 Issued in FL

Legal business name

JENNIFER TICKAL, PSY.D., P.A.

Practice address

1555 N Maitland Ave
Maitland, FL 32751-3325

Phone

(813) 563-5676

NPI assigned

Feb 16, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Jennifer Tickal, PSY.D.NPI 1073823266

Title

Clinical Psychologist

Phone

(321) 217-6086

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

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

• Jennifer Tickal, PSY.D.

  • Clinical Psychologist
  • Maitland, FL
  • NPI 1073823266
  Medicare reassignment NPD Authorized official
• James Tickal, LCSW

  • Clinical Social Worker
  • Maitland, FL
  • NPI 1093301608
  NPD

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

{
    "created_epoch": "1455580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610928000000",
    "number": "1023477221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2328 FOLIAGE OAK TER",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327667021",
            "telephone_number": "321-217-6086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 N MAITLAND AVE",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327513325",
            "telephone_number": "813-563-5676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER TICKAL, PSY.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-16",
        "last_updated": "2021-01-18",
        "certification_date": "2021-01-18",
        "status": "A",
        "authorized_official_last_name": "TICKAL",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "321-217-6086",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY8723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isabella Jaramillo
• William C Jarvis
• Jazzmine Zaniah Jeanmarie
• Precious Jariah Jeanmarie
• Jennifer Landa, LLC of Florida
• Chelsea Jennings
• Sara Jerome
• Jerry N. Shuster, MD
• Mario Jette
• Paola Anais Jimenez Monedero

• Clinical Psychologist in Maitland, FL
• Providers in Maitland, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2021; 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.