Main Line Neuropsychology, PLLC

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

PS016840 Issued in PA

Legal business name

MAIN LINE NEUROPSYCHOLOGY, PLLC

Practice address

30 S Valley Rd
Suite 207
Paoli, PA 19301-1450

Phone

(610) 500-4700

NPI assigned

May 24, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Jennifer Badgley, PHD

Title

Owner/Neuropsychologist

Phone

(610) 500-4700

Specialties & licenses 7

Addresses

Tax ID family

Main Line Neuropsychology PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Main Line Neuropsychology, PLLC

  • Psychologist
  • Malvern, PA
  • NPI 1194065524
  NPD tax ID

Locations

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

{
    "created_epoch": "1306195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458259200000",
    "number": "1851684906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 PAOLI PLZ UNIT 1448",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193015044",
            "telephone_number": "610-500-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 S VALLEY RD",
            "address_2": "SUITE 207",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011450",
            "telephone_number": "610-500-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN LINE NEUROPSYCHOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-24",
        "last_updated": "2016-03-18",
        "status": "A",
        "authorized_official_last_name": "BADGLEY",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER/NEUROPSYCHOLOGIST",
        "authorized_official_telephone_number": "610-500-4700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "PA",
            "license": "PS016840",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS016840",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "PA",
            "license": "PS016840",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS016840",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "PA",
            "license": "PS016840",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Health Service",
            "state": "PA",
            "license": "PS016840",
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "PA",
            "license": "PS016840",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Neuropsychologist in Paoli, PA
• Providers in Paoli, PA by specialty
• Clinical Neuropsychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2016; 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.