Active NPI
Growup
- Clinical Psychologist
- Lansdale, PA
National Provider Identifier
1104299767
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PS017033
- Legal business name
- GROWUP
- Practice address
- 100 W Main St
Suite 435
Lansdale, PA 19446-2019 - Phone
- (267) 273-8041
- NPI assigned
- Nov 4, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Leela Jackson, PSYD
- Title
- Licensed Clinical Psychologist
- Phone
- (267) 273-8041
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PS017033 | PA | Primary |
Addresses
Primary practice location
100 W Main St
Suite 435
Lansdale, PA 19446-2019
Mailing address
345 Leverington Ave
Philadelphia, PA 19128-4738
National Provider Directory
National Provider DirectoryLocations
100 W Main St
Ste 435
Lansdale, PA 19446
Phone (215) 412-8677
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1446595200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1446595200000",
"number": "1104299767",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "345 LEVERINGTON AVE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191284738"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 W MAIN ST",
"address_2": "SUITE 435",
"city": "LANSDALE",
"state": "PA",
"postal_code": "194462019",
"telephone_number": "267-273-8041"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GROWUP",
"organizational_subpart": "NO",
"enumeration_date": "2015-11-04",
"last_updated": "2015-11-04",
"status": "A",
"authorized_official_last_name": "JACKSON",
"authorized_official_first_name": "LEELA",
"authorized_official_title_or_position": "LICENSED CLINICAL PSYCHOLOGIST",
"authorized_official_telephone_number": "267-273-8041",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "PSYD"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychologist, Clinical",
"state": "PA",
"license": "PS017033",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lansdale, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.