Active NPI
Jason Jaegly, PSY.D.
- Clinical Psychologist
- Bala Cynwyd, PA
National Provider Identifier
1093318537
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PS019141
- Practice address
- 1 Bala Ave Ste 110
Bala Cynwyd, PA 19004-3207 - Phone
- (267) 202-4237
- NPI assigned
- Nov 18, 2020
- Last updated
- Nov 18, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PS019141 | PA | Primary |
Addresses
Primary practice location
1 Bala Ave Ste 110
Bala Cynwyd, PA 19004-3207
Mailing address
508 Auten Rd Apt 3a
Hillsborough, NJ 08844-5057
Phone (908) 295-9582
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS019141 | PA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605657600000",
"number": "1093318537",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "508 AUTEN RD APT 3A",
"city": "HILLSBOROUGH",
"state": "NJ",
"postal_code": "088445057",
"telephone_number": "908-295-9582"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 BALA AVE STE 110",
"city": "BALA CYNWYD",
"state": "PA",
"postal_code": "190043207",
"telephone_number": "267-202-4237"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAEGLY",
"first_name": "JASON",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-11-18",
"last_updated": "2020-11-18",
"certification_date": "2020-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PA",
"license": "PS019141",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bala Cynwyd, PA
- Institute for Cognitive Prosthetics Inc
- Integrative Psychological & Consulting Services
- Mekayla Dawn Jackson
- Madeia H. Jacobs
- Alyssa Rose Jacullo
- Antoine Jahshan, M.D.
- Audre L. Jarmas, PH.D.
- Jodi J Jasionowicz, D.M.D.
- Jefferson Ambulatory Surgery Services, LLC (Jeffeson Endoscopy Center at Bala)
- Jefferson Community Physicians
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.