Active NPI
Jacqueline Duci, PSY.D.
- Clinical Psychologist
- Ardmore, PA
National Provider Identifier
1265808554
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PS-004509
- Practice address
- 133 Coulter Ave
Ardmore, PA 19003-2416 - Phone
- (610) 642-4909
- NPI assigned
- Aug 20, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PS-004509 | PA | |
| Clinical Psychologist | 103TC0700X | PS-004509 | PA | Primary |
Addresses
Primary practice location
133 Coulter Ave
Ardmore, PA 19003-2416
Mailing address
2025 Wallace St
Philadelphia, PA 19130-3221
Phone (215) 232-2938
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS-004509 | PA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1440028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440028800000",
"number": "1265808554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2025 WALLACE ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191303221",
"telephone_number": "215-232-2938"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "133 COULTER AVE",
"city": "ARDMORE",
"state": "PA",
"postal_code": "190032416",
"telephone_number": "610-642-4909"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUCI",
"first_name": "JACQUELINE",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-08-20",
"last_updated": "2015-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "PA",
"license": "PS-004509",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PA",
"license": "PS-004509",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ardmore, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.