Active NPI
Holly Ruckdeschel, PH.D.
- Adult Development & Aging Psychologist
- Coatesville, PA
National Provider Identifier
1487637807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Development & Aging Psychologist
- License
- PS-006885-L
- Practice address
- 1400 Blackhorse Hill Rd
14A
Coatesville, PA 19320-2040 - Phone
- (610) 384-7711
- NPI assigned
- Nov 21, 2005
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Adult Development & Aging Psychologist | 103TA0700X | PS-006885-L | PA | Primary |
Addresses
Primary practice location
1400 Blackhorse Hill Rd
14A
Coatesville, PA 19320-2040
Mailing address
1400 Blackhorse Hill Rd
14A
Coatesville, PA 19320-2040
Phone (610) 384-7711
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS-006885-L | PA | MD | Adult Development & Aging Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184544000000",
"number": "1487637807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 BLACKHORSE HILL RD",
"address_2": "14A",
"city": "COATESVILLE",
"state": "PA",
"postal_code": "193202040",
"telephone_number": "610-384-7711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 BLACKHORSE HILL RD",
"address_2": "14A",
"city": "COATESVILLE",
"state": "PA",
"postal_code": "193202040",
"telephone_number": "610-384-7711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUCKDESCHEL",
"first_name": "HOLLY",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-11-21",
"last_updated": "2007-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "103TA0700X",
"taxonomy_group": "",
"desc": "Psychologist, Adult Development & Aging",
"state": "PA",
"license": "PS-006885-L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coatesville, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 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.