Joan Doris Jeruchim, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PS-008612-L Issued in PA

Practice address

2101 Market St Unit 3203
Philadelphia, PA 19103

Phone

(610) 644-7415

Fax

(775) 719-4764

NPI assigned

Mar 18, 2006

Last updated

Jul 15, 2018By the provider in NPPES

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 11

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1142640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531612800000",
    "number": "1558320622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 MARKET ST UNIT 3203",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191031367",
            "telephone_number": "610-644-7415",
            "fax_number": "775-719-4764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 MARKET ST UNIT 3203",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19103",
            "telephone_number": "610-644-7415",
            "fax_number": "775-719-4764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JERUCHIM",
        "first_name": "JOAN",
        "middle_name": "DORIS",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-18",
        "last_updated": "2018-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS-008612-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTI-PLAN",
            "identifier": "1260848",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BS - PA BS",
            "identifier": "JE339389",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P3264689",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MANAGED HEALTH NETWORK",
            "identifier": "186977",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA, NON-HMO",
            "identifier": "4335760",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN HEALTH SERVICES",
            "identifier": "230139000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "001661854",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMPSYCH BH CORP",
            "identifier": "1760255",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IBC - KEYSTONE",
            "identifier": "230139000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IBC - PERSONAL CHOICE",
            "identifier": "0026111000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA, HMO",
            "identifier": "4335760",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Jerrard, DO
• Jerrilyn Health Care Services
• Jerrold Friedman, M.D. LLC
• Jerry a Toomer
• Amy Marie Jersild, LCSW
• Alissa Beth Jerud, PHD
• Brian Jerusik, D.O.
• Sara E Jeruss, M. ED. C. PSYCH.
• Amanda Jervis, MS
• Janel Jesberger, PA-C

• Clinical Psychologist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Clinical Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2018; 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.