Jeannine Cicco Barker, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PS018131 Issued in PA

Practice address

255 S 17TH St Ste 2121
Philadelphia, PA 19103-6211

Phone

(215) 839-9179

NPI assigned

Dec 19, 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": "1576713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665964800000",
    "number": "1265070379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2401",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191470401",
            "telephone_number": "215-839-9179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 S 17TH ST STE 2121",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191036211",
            "telephone_number": "215-839-9179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CICCO BARKER",
        "first_name": "JEANNINE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-19",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS018131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Cicalese, CRNA
• Dawn Michelle Ciccarone
• Carissa Cicchinelli, MD
• Luke David Cicchinelli, M.D.
• Richard F Cicci, P.T.
• David Ciccolella, MD
• Emilio Ciccone, PA-C
• Patrick Edwin Ciccone, M.D.
• Michael Christopher Ciccotti, M.D.
• Michael Girard Ciccotti, M.D.

• 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 Oct 17, 2022; 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.