Jennifer Tickal, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY 8723 Issued in FL

Practice address

1555 N Maitland Ave
Maitland, FL 32751-3325

Phone

(813) 563-5676

NPI assigned

Oct 21, 2010

Last updated

Jan 18, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Jennifer Ryan Former name

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jennifer Tickal, Psy.D., P.a.

  • Clinical Psychologist
  • Maitland, FL
  • NPI 1023477221
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1287619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610928000000",
    "number": "1073823266",
    "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": "813-563-5676"
        },
        {
            "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": {
        "last_name": "TICKAL",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-21",
        "last_updated": "2021-01-18",
        "certification_date": "2021-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY 8723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "RYAN",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rachel Rebecca Thoni
• Eshana Thornton, RBT
• Thriving Hands of Care LLC
• Elizabeth Tichenor, RMHCI
• James Tickal, LCSW
• Martina Timperi II
• Andrea Tisdale
• TLC Transporting LLC
• Esther Grizelda Toe-McPherson, NP
• Larry Toler

• 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; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.