Active NPI
Elizabeth McIntyre, PHD
- Clinical Child & Adolescent Psychologist
- Stratford, NJ
National Provider Identifier
1497537989
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- License
- 35SI00715200
- Practice address
- 42 E Laurel Rd Ste 1100
Stratford, NJ 08084-1354 - Phone
- (856) 566-7036
- NPI assigned
- Oct 18, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist | 103TC2200X | PS019557 | PA | |
| Clinical Child & Adolescent Psychologist | 103TC2200X | 35SI00715200 | NJ | Primary |
Addresses
Primary practice location
42 E Laurel Rd Ste 1100
Stratford, NJ 08084-1354
Mailing address
848 N Woodstock St
Philadelphia, PA 19130-1438
Phone (919) 672-9918
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35SI00715200 | NJ | MD | Clinical Child & Adolescent Psychologist |
| PS019557 | PA | MD | Clinical Child & Adolescent Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rowansom Cares Institute | Past | Accepting new patients | |
| Rowansom Cares Institute | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Psychologist
- Stratford, NJ
- NPI 1073086369
-
- Pediatrics Physician
- Stratford, NJ
- NPI 1487624649
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1697587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697760000000",
"number": "1497537989",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "848 N WOODSTOCK ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191301438",
"telephone_number": "919-672-9918"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "42 E LAUREL RD STE 1100",
"city": "STRATFORD",
"state": "NJ",
"postal_code": "080841354",
"telephone_number": "856-566-7036"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCINTYRE",
"first_name": "ELIZABETH",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-10-18",
"last_updated": "2023-10-20",
"certification_date": "2023-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "PA",
"license": "PS019557",
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "NJ",
"license": "35SI00715200",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Stratford, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.