Active NPI
Jonathan Andrew Roberds, PSY.D.
- Clinical Psychologist
- Holland, PA
National Provider Identifier
1386829018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PS016345
- Practice address
- 82 Buck Rd
Suite 3
Holland, PA 18966-1751 - Phone
- (215) 355-4773
- NPI assigned
- Dec 31, 2007
- Sex
- Male
- Sole proprietor
- No
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 | PS016345 | PA | Primary |
Addresses
Primary practice location
82 Buck Rd
Suite 3
Holland, PA 18966-1751
Mailing address
82 Buck Rd
Suite 3
Holland, PA 18966-1751
Phone (215) 355-4773
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 |
|---|---|---|---|
| PS016345 | PA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1199059200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1199059200000",
"number": "1386829018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "82 BUCK RD",
"address_2": "SUITE 3",
"city": "HOLLAND",
"state": "PA",
"postal_code": "189661751",
"telephone_number": "215-355-4773"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "82 BUCK RD",
"address_2": "SUITE 3",
"city": "HOLLAND",
"state": "PA",
"postal_code": "189661751",
"telephone_number": "215-355-4773"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERDS",
"first_name": "JONATHAN",
"middle_name": "ANDREW",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-12-31",
"last_updated": "2007-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PA",
"license": "PS016345",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Holland, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 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.