Individual provider Active NPI

Jordan Frederick Lief, PSY.D.

  • Clinical Psychologist
  • Media, PA
National Provider Identifier
1508190158
Registry record updated Sep 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS016639 Issued in PA
Practice address
200 N Monroe St
Media, PA 19063-2908
Phone
(610) 804-5106
NPI assigned
Sep 30, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PS016639 PA Primary

Addresses

Primary practice location

200 N Monroe St
Media, PA 19063-2908

Mailing address

407 Kent Rd.
Bala Cynwyd, PA 19004
UM
Phone (610) 804-5106

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

State licenses

LicenseStateTypeSpecialty
PS016639PAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1254268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254268800000",
    "number": "1508190158",
    "addresses": [
        {
            "country_code": "UM",
            "country_name": "United States Minor Outlying Islands",
            "address_purpose": "MAILING",
            "address_type": "FGN",
            "address_1": "407 KENT RD.",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "19004",
            "telephone_number": "610-804-5106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N MONROE ST",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190632908",
            "telephone_number": "610-804-5106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEF",
        "first_name": "JORDAN",
        "middle_name": "FREDERICK",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-09-30",
        "last_updated": "2009-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS016639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Media, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2009; 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.