DR. JUDITH TEMPLE JACKSON


Address: 125 Coulter Ave, Floor 2, Ardmore, PA 19003-2410
Phone: 6106424873

DR. JUDITH TEMPLE JACKSON (NPI# 1497973911) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1497973911
Entity Type Individual
Full Name DR. JUDITH TEMPLE JACKSON
Other Name DR. JUDITH CAROL JACKSON
Credential PSYCHOLOGIST
Practice Address 125 Coulter Ave
Floor 2
Ardmore
PA 19003-2410
Practice Telephone 6106424873
Practice Fax Number 6106424886
Mailing Telephone 6106424873
Mailing Fax Number 6106424886
Enumeration Date 2007-04-22
Last Update Date 2007-07-08
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103TP0016X Psychologist
Specialization: Prescribing (Medical)
PS007219L PA Behavioral Health & Social Service Providers

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Office Location

Street Address 125 COULTER AVE
FLOOR 2
City ARDMORE
State PA
Zip Code 19003-2410

Providers in the same location

NPI Name Taxonomy Address Enumeration
1114473527 Emily Edelson Psychologist 125 Coulter Ave, Ardmore, PA 19003-2410 2016-08-27
1669672820 Susan Spencer Morrison Social Worker 125 Coulter Ave, Ardmore, PA 19003-2410 2007-07-24
1891994901 Daniel Yemin Psychologist 125 Coulter Ave, Ardmore, PA 19003-2410 2007-07-17
1083811012 Moss Alan Jackson Psychologist 125 Coulter Ave, Ardmore, PA 19003 2007-07-02
1255537809 James J Coupe IIi Psychologist 125 Coulter Ave, Ardmore, PA 19003-2410 2007-06-21
1831394600 Susan Leigh Metrick Psychologist 125 Coulter Ave, Ardmore, PA 19003-2410 2007-06-20
1780886184 Center for Psychological Services Psychologist 125 Coulter Ave, Ardmore, PA 19003 2007-06-05
1003018151 Bruce Victor Miller Psychologist 125 Coulter Ave, Ardmore, PA 19003 2007-06-01
1790993871 Eve Orlow Psychologist 125 Coulter Ave, Ardmore, PA 19003-2410 2007-05-20
1912129651 Talia Eisenstein Psychologist 125 Coulter Ave, Ardmore, PA 19003-2410 2007-05-03
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NPI Name Taxonomy Address Enumeration
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Taxonomy Information

Taxonomy Code 103TP0016X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Prescribing (Medical)

Taxonomy Definition

Those licensed psychologists who have completed specialized, post-doctoral training in psychopharmacology, passed a national proficiency examination in psychopharmacology, and who are authorized by state statute to prescribe medications, in accordance with their state law and state licensing authority, for the evaluation, diagnosis, management and treatment of mental, nervous, emotional, behavioral, and related disorders.
Notes: Source: Louisiana Academy of Medical Psychologists Note: Some states issue licenses under Medical Psychologist. [1/1/2007: new]

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Competitor

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City ARDMORE
Zip Code 19003

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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