Corrie L Jackson, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

Practice address

4 Terry Dr
Suite 11
Newtown, PA 18940-1838

Phone

(267) 454-1831

NPI assigned

Apr 7, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Corrie L Schoffstall Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2017 through Jan 1, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1396828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396828800000",
    "number": "1740608728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "243 RUMFORD CT",
            "city": "NEWTOWN",
            "state": "PA",
            "postal_code": "189401773",
            "telephone_number": "412-841-2833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 TERRY DR",
            "address_2": "SUITE 11",
            "city": "NEWTOWN",
            "state": "PA",
            "postal_code": "189401838",
            "telephone_number": "267-454-1831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "CORRIE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-07",
        "last_updated": "2014-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CORRIE",
            "last_name": "SCHOFFSTALL",
            "middle_name": "L",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Integrative Mental Health Services LLC
• Amy Ip, LAC, DAC
• Irene Marie Erckert, PH.D., P.C.
• Brad Isserman, PH.D
• Joseph John Iuliano, D.M.D.
• Lisa C Jacobson, PSY.D.
• Allan Jaffe, D.P.M.
• Deion Malik James
• Lisa James, RDN
• Robert Joseph Jann Sr., PHD

• Psychologist in Newtown, PA
• Providers in Newtown, PA by specialty
• Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2014; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.