Jesse J. Suh, Psy.D. LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PS016534 Issued in PA

Legal business name

JESSE J. SUH, PSY.D. LLC

Practice address

1601 Walnut St Ste 1128
Philadelphia, PA 19102-2913

Phone

(215) 207-9373

NPI assigned

Oct 5, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Jesse Jong-Shik Suh, PSY.D.

Title

Clinical Psychologist

Phone

(215) 207-9373

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1475625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576108800000",
    "number": "1144770884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 WALNUT ST STE 1128",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191022913",
            "telephone_number": "215-207-9373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 WALNUT ST STE 1128",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191022913",
            "telephone_number": "215-207-9373"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1166 Dekalb Pike Ste 109",
            "address_purpose": "LOCATION",
            "city": "Blue Bell",
            "state": "PA",
            "postal_code": "194221844",
            "country_code": "US",
            "telephone_number": "215-207-9373",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JESSE J. SUH, PSY.D. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-05",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A",
        "authorized_official_last_name": "SUH",
        "authorized_official_first_name": "JESSE",
        "authorized_official_middle_name": "JONG-SHIK",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "215-207-9373",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS016534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Clinical Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2019; 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.