Individual provider Active NPI

Chesha Simon, PSYD

  • Clinical Psychologist
  • Philadelphia, PA
National Provider Identifier
1831736461
Registry record updated Dec 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS018788 Issued in PA
Practice address
3300 Henry Ave Ste 113
Philadelphia, PA 19129-1146
Phone
(917) 583-0236
NPI assigned
Dec 2, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PS018788 PA Primary

Addresses

Primary practice location

3300 Henry Ave Ste 113
Philadelphia, PA 19129-1146

Mailing address

144 S Morton Ave Apt A46
Morton, PA 19070-2069
Phone (917) 583-0236

Other practice location 1

40 Martin Gross Dr
Langhorne, PA 19047-1616
Phone (917) 583-0236

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PS018788PAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1575244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575244800000",
    "number": "1831736461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 S MORTON AVE APT A46",
            "city": "MORTON",
            "state": "PA",
            "postal_code": "190702069",
            "telephone_number": "917-583-0236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 HENRY AVE STE 113",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191291146",
            "telephone_number": "917-583-0236"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "40 Martin Gross Dr",
            "address_purpose": "LOCATION",
            "city": "Langhorne",
            "state": "PA",
            "postal_code": "190471616",
            "country_code": "US",
            "telephone_number": "917-583-0236",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMON",
        "first_name": "CHESHA",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-02",
        "last_updated": "2019-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS018788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2019; 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.