Individual provider Active NPI

Jennifer Ann Engelhardt, PSYD

  • Psychologist
  • Philadelphia, PA
National Provider Identifier
1295355543
Registry record updated Aug 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PS019069 Issued in PA
Practice address
8201 Henry Ave Apt Q15
Philadelphia, PA 19128-2248
Phone
(973) 769-6182
NPI assigned
Apr 16, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PS019069 PA Primary

Addresses

Primary practice location

8201 Henry Ave Apt Q15
Philadelphia, PA 19128-2248

Mailing address

8201 Henry Ave Apt Q15
Philadelphia, PA 19128-2248
Phone (973) 769-6182

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

LicenseStateTypeSpecialty
PS019069PAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1586995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597190400000",
    "number": "1295355543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8201 HENRY AVE APT Q15",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191282248",
            "telephone_number": "973-769-6182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8201 HENRY AVE APT Q15",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191282248",
            "telephone_number": "973-769-6182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGELHARDT",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-16",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS019069",
            "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 Aug 12, 2020; 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.