Jennifer King, PH.D.

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

PS019502 Issued in PA

Practice address

255 S 17TH St Ste 1106
Philadelphia, PA 19103-6212

Phone

(267) 980-0294

NPI assigned

Jun 17, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1655424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1427789874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 EDITH DR",
            "city": "LAWRENCEVILLE",
            "state": "NJ",
            "postal_code": "086482032",
            "telephone_number": "267-980-0294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 S 17TH ST STE 1106",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191036212",
            "telephone_number": "267-980-0294"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6 Edith Dr",
            "address_purpose": "LOCATION",
            "city": "Lawrenceville",
            "state": "NJ",
            "postal_code": "086482032",
            "country_code": "US",
            "telephone_number": "267-980-0294",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KING",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-17",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "PA",
            "license": "PS019502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emmanuel S King, MD
• Ethan King
• Ingrid Grace King, LPC
• Jacob King
• James Michael King
• Jennifer King, LSW
• Jennifer Leigh King, MA, BCBA
• Jonathan King
• Julia King, M.S.
• Kate E King

• Counseling Psychologist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Counseling Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.