Active NPI
Linda Ann Petti, PHD
- Clinical Psychologist
- Jenkintown, PA
National Provider Identifier
1295707305
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PS003471L
- Practice address
- 1250 Greenwood Ave
Suite 4
Jenkintown, PA 19046-2901 - Phone
- (215) 885-2990
- Fax
- (215) 885-2366
- NPI assigned
- Feb 2, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PS003471L | PA | Primary |
Addresses
Primary practice location
1250 Greenwood Ave
Suite 4
Jenkintown, PA 19046-2901
Mailing address
1250 Greenwood Ave
Suite 4
Jenkintown, PA 19046-2901
Phone (215) 885-2990
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 031066 | Other | PA | BLUE SHIELD |
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS003471L | PA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138838400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1477440000000",
"number": "1295707305",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1250 GREENWOOD AVE",
"address_2": "SUITE 4",
"city": "JENKINTOWN",
"state": "PA",
"postal_code": "190462901",
"telephone_number": "215-885-2990",
"fax_number": "215-885-2366"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1250 GREENWOOD AVE",
"address_2": "SUITE 4",
"city": "JENKINTOWN",
"state": "PA",
"postal_code": "190462901",
"telephone_number": "215-885-2990",
"fax_number": "215-885-2366"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETTI",
"first_name": "LINDA",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-02-02",
"last_updated": "2016-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PA",
"license": "PS003471L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "031066",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.