Individual provider Active NPI

Marta Rusten Macdougall, PSY.D.

  • Clinical Psychologist
  • Jenkintown, PA
National Provider Identifier
1336290717
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS015570 Issued in PA
Practice address
512 West Ave
Jenkintown, PA 19046-2725
Phone
(215) 885-1835
Fax
(215) 885-8510
NPI assigned
Jan 14, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PS015570 PA Primary

Addresses

Primary practice location

512 West Ave
Jenkintown, PA 19046-2725

Mailing address

498 Lincoln Ave
Willow Grove, PA 19090-2636
Phone (215) 657-1810

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

LicenseStateTypeSpecialty
PS015570PAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Monroe Psychology, P.C. Clinical PastSince Dec 5, 2021 Accepting new patients
Diane Langberg PHD & Martha D Langberg Associates Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1168732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336290717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "498 LINCOLN AVE",
            "city": "WILLOW GROVE",
            "state": "PA",
            "postal_code": "190902636",
            "telephone_number": "215-657-1810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 WEST AVE",
            "city": "JENKINTOWN",
            "state": "PA",
            "postal_code": "190462725",
            "telephone_number": "215-885-1835",
            "fax_number": "215-885-8510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACDOUGALL",
        "first_name": "MARTA",
        "middle_name": "RUSTEN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS015570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jenkintown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.