Individual provider Active NPI

Casey Laduke, PHD

  • Psychologist
  • Philadelphia, PA
National Provider Identifier
1194172312
Registry record updated May 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
230 S Broad St Ste 1005
Philadelphia, PA 19102-4105
Phone
(215) 988-9911
NPI assigned
May 17, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X
Forensic Psychologist 103TF0200X
Psychologist 103T00000X Primary

Addresses

Primary practice location

230 S Broad St Ste 1005
Philadelphia, PA 19102-4105

Mailing address

230 S Broad St Ste 1005
Philadelphia, PA 19102-4105

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250730001268 PA Practitioner - Clinical Psychologist 9739477290 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Diversified Psychological Resources, P.C.Group PAC ID 0941475628, 2 clinicians

Practice addresses (Care Compare)

230 S Broad St
Suite 1005
Philadelphia, PA 19102-4105
Phone (215) 988-9911

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Diversified Psychological Resources, P.C. Clinical Neuropsychologist CurrentSince Jun 1, 2025 Accepting new patients
Jefferson University Physicians PastSince May 18, 2025 Accepting new patients

Locations

230 S Broad St
Ste 1005
Philadelphia, PA 19102
Phone (215) 988-9911

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1463443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747353600000",
    "number": "1194172312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 S BROAD ST STE 1005",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191024105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 S BROAD ST STE 1005",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191024105",
            "telephone_number": "215-988-9911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LADUKE",
        "first_name": "CASEY",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-17",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.