Mary Elizabeth Ertel, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PS016105 Issued in PA

Practice address

1024 E Lancaster Ave
Bryn Mawr, PA 19010-1409

Phone

(610) 525-1599

Fax

(610) 525-1599

NPI assigned

Jun 30, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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": "1309392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309392000000",
    "number": "1457648206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1024 E LANCASTER AVE",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190101409",
            "telephone_number": "610-525-1599",
            "fax_number": "610-525-1599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1024 E LANCASTER AVE",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190101409",
            "telephone_number": "610-525-1599",
            "fax_number": "610-525-1599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERTEL",
        "first_name": "MARY ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-30",
        "last_updated": "2011-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS016105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA ACT 48 PROFESSIONAL PERSONNEL ID",
            "identifier": "3010503",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA STATE LICENSE NUMBER",
            "identifier": "PS016105",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William David Emper, M.D.
• Stacey E. Englander-Turner, M.D.
• Sravya Ennamuri
• William Scott Enochs, M.D., PH.D.
• Jacey Erickson
• Laura Escalona
• Eli Eshaghian, DO
• Sarah Espenshade, LCSW
• Adrian Tabuena Estepa, MD
• Joseph Peter Evans, DPM

• Clinical Psychologist in Bryn Mawr, PA
• Providers in Bryn Mawr, PA by specialty
• Clinical Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2011; 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.