Jillen B. Axelrod, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

006539 Issued in NY

Practice address

96 5TH Ave Apt 1D
New York, NY 10011-7604

Phone

(212) 505-1963

NPI assigned

May 11, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1525996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525996800000",
    "number": "1083104442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 5TH AVE APT 1D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100117604",
            "telephone_number": "212-505-1963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 5TH AVE APT 1D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100117604",
            "telephone_number": "212-505-1963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AXELROD",
        "first_name": "JILLEN",
        "middle_name": "B.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-11",
        "last_updated": "2018-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "006539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandon Harris Axelrod, DDS
• Cayla Axelrod
• Deborah M Axelrod, MD
• Felicia B. Axelrod, M.D.
• Frederick Wayne Axelrod, M.D.
• Judith Axelrod, MD
• Karen Stephanie Axelrod, PH.D. CLINICAL PSYCH
• Kobi Axelrod, MD
• Meryl Axelrod
• Michael Standard Axelrod, LMSW

• Clinical Psychologist in New York, NY
• Providers in New York, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.