Active NPI
Shoshana Wortman, PSY.D.
- Clinical Psychologist
- Blue Bell, PA
National Provider Identifier
1326315904
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PS017124
- Practice address
- 583 Skippack Pike Ste 410
Blue Bell, PA 19422-2146 - Phone
- (267) 289-1570
- NPI assigned
- Nov 26, 2011
- 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 | PS017124 | PA | Primary |
Addresses
Primary practice location
583 Skippack Pike Ste 410
Blue Bell, PA 19422-2146
Mailing address
3204 Shawnee GRN
Ambler, PA 19002-3638
Phone (215) 341-1738
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 |
|---|---|---|---|
| PS017124 | PA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1322265600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666310400000",
"number": "1326315904",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3204 SHAWNEE GRN",
"city": "AMBLER",
"state": "PA",
"postal_code": "190023638",
"telephone_number": "215-341-1738"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "583 SKIPPACK PIKE STE 410",
"city": "BLUE BELL",
"state": "PA",
"postal_code": "194222146",
"telephone_number": "267-289-1570"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WORTMAN",
"first_name": "SHOSHANA",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-11-26",
"last_updated": "2022-10-21",
"certification_date": "2022-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PA",
"license": "PS017124",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Blue Bell, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.