Sheri Jill Balsam, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PS018873 Issued in PA

Practice address

1930 S Broad St Unit 11
Philadelphia, PA 19145-2328

Phone

(800) 897-5252

NPI assigned

Sep 4, 2019

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

State licenses

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

{
    "created_epoch": "1567555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567555200000",
    "number": "1144879032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4041 RIDGE AVE APT 18508",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191291557",
            "telephone_number": "516-732-1735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 S BROAD ST UNIT 11",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191452328",
            "telephone_number": "800-897-5252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALSAM",
        "first_name": "SHERI",
        "middle_name": "JILL",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-04",
        "last_updated": "2019-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS018873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Balmont Family Practice Group P.C.
• Zubair W Baloch, MD
• Douglas Balogun
• Evelyn Kemi Balogun, MD,MPH
• Oluwanifemi Tolulase Balogun, MD
• Sheri Balsara
• Eli Balshan
• William Robert Balshem, PT, DPT
• Oksana Baltarowich, M.D.
• Madison Baltazar, DO

• 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 Sep 4, 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.