Individual provider Active NPI

Jennifer L Marshall, PH.D.

  • Clinical Psychologist
  • Martinsburg, WV
National Provider Identifier
1124287040
Registry record updated Jun 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS019898 Issued in PA
Practice address
510 Butler Ave
Martinsburg, WV 25405-9990
Phone
(304) 263-0811
Fax
(304) 262-1417
NPI assigned
Jun 5, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PS019898 PA Primary

Addresses

Primary practice location

510 Butler Ave
Martinsburg, WV 25405-9990

Mailing address

61 Roycroft Ave
Pittsburgh, PA 15228-1806
Phone (571) 243-7987

Other practice location 1

61 Roycroft Ave
Pittsburgh, PA 15228-1806
Phone (571) 243-7987

Other identifiers 1

IdentifierTypeStateIssuer
PS019898OtherPAPA BOARD OF PSYCHOLOGY

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PS019898PAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1212624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750118400000",
    "number": "1124287040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 ROYCROFT AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152281806",
            "telephone_number": "571-243-7987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 BUTLER AVE",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254059990",
            "telephone_number": "304-263-0811",
            "fax_number": "304-262-1417"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "61 Roycroft Ave",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152281806",
            "country_code": "US",
            "telephone_number": "571-243-7987",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-05",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS019898",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA BOARD OF PSYCHOLOGY",
            "identifier": "PS019898",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinsburg, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2025; 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.