Jeffrey Lawrence Eiberson, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PA LIC. #PS002959L Issued in PA

Practice address

1326 Spruce St
Suite #1905
Philadelphia, PA 19107-5826

Phone

(215) 546-1767

NPI assigned

Jan 21, 2006

Sex

Male

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 4

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, 1977

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1137801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629058870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1326 SPRUCE ST",
            "address_2": "SUITE #1905",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075826",
            "telephone_number": "215-546-1767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1326 SPRUCE ST",
            "address_2": "SUITE #1905",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075826",
            "telephone_number": "215-546-1767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EIBERSON",
        "first_name": "JEFFREY",
        "middle_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PA LIC. #PS002959L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN HEALTH CARE",
            "identifier": "246945000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HEALTH CARE",
            "identifier": "4365980",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHEILD",
            "identifier": "438240",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC PERSONAL CHOICE",
            "identifier": "0063120000",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lori Ehrlich, M.D.
• Marni Lyn Ehrlich, OTR/L
• Syeda Sarah Ehsen
• Jonas Ehudin
• Hormoz Ehya, M.D.
• Hannah M Eichen, DMD
• Eric C Eichenwald, MD
• Cherie Eichholz, DSW, LCSW
• Jessica Renee Eichner, CPNP-AC
• Kerry Eid, PT, DPT

• 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 8, 2007; 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.