Active NPI
Marianne E. Intoccia, PHD
- Clinical Psychologist
- Fort Washington, PA
National Provider Identifier
1780896787
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PS004932L
- Practice address
- 426 Pennsylvania Ave.
Suite 101
Fort Washington, PA 19034 - Phone
- (215) 628-3440
- NPI assigned
- May 4, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PS004932L | PA | Primary |
Addresses
Primary practice location
426 Pennsylvania Ave.
Suite 101
Fort Washington, PA 19034
Mailing address
588 Fawnview Circle
Blue Bell, PA 19422-1386
Phone (215) 661-1213
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070925000344 | PA | Practitioner - Clinical Psychologist | 1153415856 | Practice locations: Ambler, PA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
158 E Butler Ave
Ambler, PA 19002-4436
Phone (484) 919-1856
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS004932L | PA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1780896787",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "588 FAWNVIEW CIRCLE",
"city": "BLUE BELL",
"state": "PA",
"postal_code": "194221386",
"telephone_number": "215-661-1213"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "426 PENNSYLVANIA AVE.",
"address_2": "SUITE 101",
"city": "FORT WASHINGTON",
"state": "PA",
"postal_code": "19034",
"telephone_number": "215-628-3440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "INTOCCIA",
"first_name": "MARIANNE",
"middle_name": "E.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PA",
"license": "PS004932L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Washington, PA
Sources for this page
- 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.