Jennifer Lynn Moline

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PS019521 Issued in PA

Practice address

2300 Computer Rd Ste C15
Willow Grove, PA 19090-1735

Phone

(484) 440-9740

NPI assigned

Feb 21, 2022

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Dragonfly Psychological Associates

  • Clinical Psychologist
  • Media, PA
  • NPI 1831658376
  NPD (past)

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

{
    "created_epoch": "1645401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645401600000",
    "number": "1841945656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 COMPUTER RD STE C15",
            "city": "WILLOW GROVE",
            "state": "PA",
            "postal_code": "190901735",
            "telephone_number": "484-440-9740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 COMPUTER RD STE C15",
            "city": "WILLOW GROVE",
            "state": "PA",
            "postal_code": "190901735",
            "telephone_number": "484-440-9740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLINE",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-21",
        "last_updated": "2022-02-21",
        "certification_date": "2022-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS019521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine M Mishalko, MSS,ATC,PES
• Jeshal Mistry
• Angelina Mitchell, PHARMD
• Erica Mohan
• Monica Mohile, M.D.
• Montgomery County Advanced Medical Imaging, LLC
• Audrey Moody, LSW
• Carol Therese Moore
• Jennifer Moore, PSYD
• Rowan Gillian Moore, LCSW

• Clinical Psychologist in Willow Grove, PA
• Providers in Willow Grove, PA by specialty
• Clinical Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2022; 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.