Active NPI
Joanna Petrides, PSY.D.
- Psychologist
- Mullica Hill, NJ
National Provider Identifier
1821496936
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 35SI00553000
- Practice address
- 700 Mullica Hill Rd
Mullica Hill, NJ 08062-4413 - Phone
- (856) 508-1000
- NPI assigned
- Dec 5, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PS017752 | PA | |
| Psychologist | 103T00000X | 35SI00553000 | NJ | Primary |
| Clinical Psychologist | 103TC0700X | 35SI00553000 | NJ | |
| Clinical Psychologist | 103TC0700X | PS017752 | PA |
Addresses
Primary practice location
700 Mullica Hill Rd
Mullica Hill, NJ 08062-4413
Mailing address
700 Mullica Hill Rd
Mullica Hill, NJ 08062-4413
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0499056 | Medicaid | NJ |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jpetrides136200@directvirtua.org | ||
| Direct Messaging Address | jpetrides136200@directvirtua.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 81.15 of 100
- Quality
- 62.28
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 74.89
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35SI00553000 | NJ | MD | Psychologist |
| PS017752 | PA | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Virtua Medical Group, PA | Current | Accepting new patients | |
| Virtua Medical Group, PA | Current | Accepting new patients | |
| Virtua Medical Group, PA | Current | Accepting new patients | |
| Rowansom Dept of Obstetrics Gynecology | Past | Accepting new patients |
Locations
3242 Route 206
Ste 2
Bordentown, NJ 08505
Phone (609) 298-4340
405 Hurffville Crosskeys Rd
Ste 101
Sewell, NJ 08080
Phone (856) 218-0300
42 E Laurel Rd
Ste 1700
Stratford, NJ 08084
Phone (856) 482-9000
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Medicine Physician
- Marlton, NJ
- NPI 1649226515
-
- Urgent Care Clinic/Center
- Cherry Hill, NJ
- NPI 1164972998
-
- Orthopaedic Surgery Physician
- Delran, NJ
- NPI 1841087988
-
- Obstetrics & Gynecology Physician
- Stratford, NJ
- NPI 1891765053
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1417737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757289600000",
"number": "1821496936",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 MULLICA HILL RD",
"city": "MULLICA HILL",
"state": "NJ",
"postal_code": "080624413"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 MULLICA HILL RD",
"city": "MULLICA HILL",
"state": "NJ",
"postal_code": "080624413",
"telephone_number": "856-508-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETRIDES",
"first_name": "JOANNA",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-12-05",
"last_updated": "2025-09-08",
"certification_date": "2025-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "PA",
"license": "PS017752",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NJ",
"license": "35SI00553000",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NJ",
"license": "35SI00553000",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PA",
"license": "PS017752",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0499056",
"state": "NJ"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jpetrides136200@directvirtua.org",
"affiliation": "N",
"address_1": "42 E Laurel Rd Ste 2100-A1",
"city": "Stratford",
"state": "NJ",
"country_code": "US",
"postal_code": "080841354",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jpetrides136200@directvirtua.org",
"affiliation": "N",
"address_1": "405 Hurffville Crosskeys Rd Ste 101",
"city": "Sewell",
"state": "NJ",
"country_code": "US",
"postal_code": "080809340",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Mullica Hill, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2025; 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.