Julie Pelletier, PHD

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

PS017889 Issued in PA

Practice address

905 W. Governor Road
Suite 200
Hershey, PA 17033-2307

Phone

(717) 531-7235

Fax

(717) 531-0067

NPI assigned

May 21, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ayama Psychotherapy LLCGroup PAC ID 8123309945, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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

• Ayama Psychotherapy LLC

  • Psychologist
  • Lemont, PA
  • NPI 1932655990
  Medicare reassignment Care Compare group NPD
• The Milton S Hershey Medical Center Physician Group

  • Neurology Physician
  • Hershey, PA
  • NPI 1629043203
  NPD (past)
• The Milton S. Hershey Medical Center Physicians Group

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Hershey, PA
  • NPI 1255482089
  NPD (past)

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

{
    "created_epoch": "1274400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472774400000",
    "number": "1477872000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 858, MCA410",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170330858",
            "telephone_number": "800-243-1455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 W. GOVERNOR ROAD",
            "address_2": "SUITE 200",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170332307",
            "telephone_number": "717-531-7235",
            "fax_number": "717-531-0067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLETIER",
        "first_name": "JULIE",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-21",
        "last_updated": "2016-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "UT",
            "license": "7569599-2501",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "PA",
            "license": "TPS030297",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "PA",
            "license": "PS017889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Lauren Peck
• Pediatric Physical Therapy, Inc
• Richard C Pees, MD
• Kathleen T. Peires, CRNP
• Elizabeth R Peitzman, PA-C
• Penn State Health Home Recovery Care, LLC
• Penn State Health Medical Group, LLC
• Penn State Medical Center
• Nina Pennock, CRNA
• Pennsylvania CVS Pharmacy, L.L.C.

• Clinical Child & Adolescent Psychologist in Hershey, PA
• Providers in Hershey, PA by specialty
• Clinical Child & Adolescent Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.