DR. ALYCE JACKSON (NPI# 1639372089) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639372089 |
| Entity Type | Individual |
| Full Name | DR. ALYCE JACKSON |
| Credential | PH.D. |
| Practice Address |
1616 Walnut St Suite 910 Philadelphia PA 19103-5313 |
| Mailing Address |
922 Pine St 2-r Philadelphia PA 19107-6100 |
| Practice Telephone | 2159222826 |
| Mailing Telephone | 2159222826 |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PS-006130-L | PA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053419119 | Alyce F Jackson | Physical Medicine & Rehabilitation | 375 N Wall St Ste P520, Kankakee, IL 60901-3493 | 2006-09-20 |
| 1023502499 | Alyce Jackson | Technician | 1701 N Green Valley Pkwy Ste 9a, Henderson, NV 89074-5991 | 2018-06-19 |
| Street Address |
1616 WALNUT ST SUITE 910 |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19103-5313 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639177744 | Joseph T. Ruhl Jr. | Physical Therapist | 1616 Walnut St, Suite 210, Philadelphia, PA 19103-5313 | 2005-07-12 |
| 1154689826 | Jessica Anderson | Psychologist | 1616 Walnut St, 2108, Philadelphia, PA 19103-5313 | 2012-05-01 |
| 1235424300 | Ellen Singer Coleman | Social Worker | 1616 Walnut St, Suite 1108, Philadelphia, PA 19103-5313 | 2011-06-16 |
| 1366750515 | Danna R. Bodenheimer | Social Worker | 1616 Walnut St, Suite 1610, Philadelphia, PA 19103-5313 | 2010-09-22 |
| 1396051389 | Rittenhouse Sleep Medicine LLC | Psychiatry & Neurology | 1616 Walnut St, 312-c, Philadelphia, PA 19103-5313 | 2010-08-27 |
| 1124262530 | Robert M. Toborowsky | Psychiatry & Neurology | 1616 Walnut St, Suite 1116, Philadelphia, PA 19103-5313 | 2009-04-29 |
| 1164673596 | Susan Mary Moslow | Psychologist | 1616 Walnut St, Suite 1108, Philadelphia, PA 19103-5313 | 2008-10-03 |
| 1679735880 | Rachel Ginzberg | Psychologist | 1616 Walnut St, Suite 806, Philadelphia, PA 19103-5313 | 2008-06-28 |
| 1619164563 | David Gregory Digiovanni | Physical Therapist | 1616 Walnut St, Lower Lobby, Philadelphia, PA 19103-5313 | 2007-09-25 |
| 1053516427 | Julie Lynn Everett | Physical Therapist | 1616 Walnut St, Suite 210, Philadelphia, PA 19103-5313 | 2007-06-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518565431 | Allyson Caputa | Behavior Technician | 100 North 18th Street, Suite 300, Philadelphia, PA 19103 | 2020-10-13 |
| 1063062685 | Sarah Seeling | Social Worker | 255 South 17th Street Suite 1010, Suite 1500, Suite 23, Philadelphia, PA 19103 | 2019-09-16 |
| 1730735051 | Jill Verofsky | Counselor | 1180 Jfk Blvd, Suite 1110, Philadelphia, PA 19103 | 2019-08-13 |
| 1932761863 | Barclay Prescription Pharmacy | Pharmacist | 1736 Spruce St, Phila, PA 19103 | 2019-07-01 |
| 1265910459 | Whitney Sue Fricke | Counselor | 2211 Locust St, Philadelphia, PA 19103 | 2018-07-31 |
| 1740784586 | Sara Elizabeth Macintyre | Speech-Language Pathologist | 1845 Walnut Street Suite 1540, Philadelphia, PA 19103 | 2018-03-19 |
| 1326578907 | Danielle D Bercovitch | Speech-Language Pathologist | 1930 S Broad, Philadelphia, PA 19103 | 2017-06-15 |
| 1598114449 | Brooke Elaine Mullen | Dietitian, Registered | 1708 Pine St Apt 1r, Philadelphia, PA 19103 | 2016-06-10 |
| 1972966026 | Alexandra Brady Jatzke | Dietitian, Registered | 1835 Market St Fl 2, Philadelphia, PA 19103 | 2016-04-05 |
| 1932574118 | David Clements Iv | Psychiatry & Neurology | 1845 Walnut St Ste 1540, Philadelphia, PA 19103 | 2015-12-14 |
| Find all providers in zip 19103 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447851092 | Erica Marla Schulte | Psychologist | 3535 Market St Ste 3032, Philadelphia, PA 19104-3313 | 2020-11-02 |
| 1376159780 | Kristi Corcoran | Psychologist | 212 Catharine St Apt 5, Philadelphia, PA 19147-3398 | 2020-09-21 |
| 1033723317 | Casey Joan Zampella | Psychologist | 2716 South St Ofc 5322, Philadelphia, PA 19146-2305 | 2020-09-03 |
| 1265053755 | Shirley Brown | Psychologist | 210 W Rittenhouse Sq Ste 404, Philadelphia, PA 19103-5771 | 2020-05-06 |
| 1518507912 | Tamara Christine Hill | Psychologist | 245 Cherry St Apt 3f, Philadelphia, PA 19106-1991 | 2020-01-14 |
| 1023658168 | Susan Schack Kelly | Psychologist | 8609 Germantown Ave # 2f, Philadelphia, PA 19118-2863 | 2020-01-07 |
| 1265070379 | Jeannine Cicco Barker | Psychologist | 100 S Broad St Ste 915, Philadelphia, PA 19110-1016 | 2019-12-19 |
| 1003453952 | Bridget Smith | Psychologist | Stratton Hall, 3201 Chestnut St., 2nd Floor, Philadelphia, PA 19146 | 2019-12-10 |
| 1235790007 | Stephanie Manasse | Psychologist | 3201 Chestnut St, Philadelphia, PA 19104-3370 | 2019-06-24 |
| 1003376690 | Margaux Desjardins | Psychologist | 2200 Saint James Pl, Philadelphia, PA 19103-5502 | 2019-03-21 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19103 |
Please comment or provide details below to improve the information on DR. ALYCE JACKSON.
| 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.