Active NPI
Dorothy Latella-Zakhireh, PSY.D.
- Clinical Psychologist
- Philadelphia, PA
National Provider Identifier
1285009696
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 017489
- Practice address
- 1930 S Broad St
Ima
Philadelphia, PA 19145 - Phone
- (856) 220-2276
- NPI assigned
- Dec 10, 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 |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | 017489 | PA | |
| Clinical Psychologist | 103TC0700X | 017489 | PA | Primary |
Addresses
Primary practice location
1930 S Broad St
Ima
Philadelphia, PA 19145
Mailing address
9 Durham CT
Voorhees, NJ 08043-2951
Phone (856) 220-2276
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 017489 | PA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1449705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1449705600000",
"number": "1285009696",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 DURHAM CT",
"city": "VOORHEES",
"state": "NJ",
"postal_code": "080432951",
"telephone_number": "856-220-2276"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1930 S BROAD ST",
"address_2": "IMA",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "19145",
"telephone_number": "856-220-2276"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LATELLA-ZAKHIREH",
"first_name": "DOROTHY",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-12-10",
"last_updated": "2015-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "PA",
"license": "017489",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PA",
"license": "017489",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 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.