JESSICA G KEROACK (NPI# 1720516305) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720516305 |
| Entity Type | Individual |
| Full Name | JESSICA G KEROACK |
| Credential | PHD |
| Practice Address |
264 E Broad St Bethlehem PA 18018-6278 |
| Practice Telephone | (610) 866-9311 |
| Practice Fax Number | 6108822072 |
| Mailing Telephone | 6108669311 |
| Mailing Fax Number | 6108822072 |
| Enumeration Date | 2017-05-26 |
| Last Update Date | 2018-12-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | PS018293 | PA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | STATE LICENSE | PS018293 | 01 |
| Street Address |
264 E BROAD ST |
| City | BETHLEHEM |
| State | PA |
| Zip Code | 18018-6278 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518954742 | Thomas D Sugalski | Psychologist | 264 E Broad St, Bethlehem, PA 18018-6224 | 2005-10-03 |
| 1336630201 | Christine J Lynch | Counselor | 264 E Broad St, Bethlehem, PA 18018-6278 | 2018-05-25 |
| 1316491061 | Bethany Detwiler | Psychologist | 264 E Broad St, Bethlehem, PA 18018-6278 | 2016-08-11 |
| 1528425097 | Abby Sheneman | Social Worker | 264 E Broad St, Bethlehem, PA 18018-6278 | 2016-01-28 |
| 1982954723 | Julie L Iwanicki | Marriage & Family Therapist | 264 E Broad St, Bethlehem, PA 18018-6278 | 2012-09-19 |
| 1548535057 | Jennifer Lee Brisbane | Psychologist | 264 E Broad St, Bethlehem, PA 18018-6278 | 2012-03-16 |
| 1528358819 | Jenna L Jebitsch | Counselor | 264 E Broad St, Bethlehem, PA 18018-6278 | 2011-04-08 |
| 1558689174 | Marifel Estrada-currie | Psychologist | 264 E Broad St, Bethlehem, PA 18018-6278 | 2010-05-06 |
| 1114947975 | Luba Rafalson | Psychologist | 264 E Broad St, Bethlehem, PA 18018-6224 | 2006-07-21 |
| 1346201266 | Deborah Ferraro | Social Worker | 264 E Broad St, Bethlehem, PA 18018-6224 | 2006-03-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093373292 | Jade Madison Hennessy | Specialist/Technologist | Moravian College, 1200 Main Street, Bethlehem, PA 18018 | 2019-06-03 |
| 1780106179 | Courtney Jane Kruscavage | Specialist/Technologist | 641 Dellwood Street, Bethlehem, PA 18018 | 2017-07-07 |
| 1205357936 | Balanced Body Therapeutic Massage, LLC | Massage Therapist | 227 W Broad St Ste 102, Bethlehem, PA 18018 | 2017-07-03 |
| 1033567599 | Jessamine Martin | Counselor | 1 East Broad Street, Suite 510, Bethlehem, PA 18018 | 2016-05-25 |
| 1841650041 | Akhi Saha | Internal Medicine | 325 W Broad St Fl 1, Bethlehem, PA 18018 | 2016-03-01 |
| 1063804193 | Paul Minh Le | Internal Medicine | 800 Eaton Ave Ste B, Bethlehem, PA 18018 | 2015-02-26 |
| 1578962841 | Elizabeth Veronica Weiss Iobst | Counselor | 1754 W. Broad St., Bethlehem, PA 18018 | 2014-08-22 |
| 1255771739 | Inner Resources Counseling Inc | Counselor | 807 West Broad St, Bethlehem, PA 18018 | 2013-06-28 |
| 1437404878 | St Luke Hospital | General Acute Care Hospital | 1956 C Allwood Dr., Bethlehem, PA 18018 | 2012-07-23 |
| 1275802944 | St. Luke's Physician Group, Inc | Ophthalmology | 800 Eaton Avenue, Suite 101, Bethlehem, PA 18018 | 2011-12-23 |
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| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881225423 | Susan Marie Hannan | Psychologist | 1 E Broad St Ste 510, Bethlehem, PA 18018-5964 | 2020-02-02 |
| 1013547322 | John A Abbruzzese IIi | Psychologist | 2638 West Blvd, Bethlehem, PA 18017-4038 | 2020-01-26 |
| 1619348760 | Karen E Landman | Psychologist | 1600 Spring Valley Rd, Bethlehem, PA 18015-9077 | 2015-10-15 |
| 1790189124 | Joanne Morth | Psychologist | 1 Bethlehem Plaza, Suite 810, Bethlehem, PA 18108 | 2014-10-14 |
| 1407183957 | Point North Psychology Group | Psychologist | 167 N Commerce Way, Suite 105, Bethlehem, PA 18017-8973 | 2009-11-04 |
| 1649499088 | Robert E Wisser | Psychologist | 1016 W Broad St, Bethlehem, PA 18018-5039 | 2007-04-24 |
| 1104978899 | Arthur W. Lyons | Psychologist | 1200 Main St., Bethlehem, PA 18018 | 2007-01-16 |
| 1881764090 | Katherine L Muller | Psychologist | 3005 Brodhead Rd Ste 105, Bethlehem, PA 18020-9299 | 2006-11-08 |
| 1144271545 | Janice N Young | Psychologist | 35 East Elizabeth Ave, Ste 23, Bethlehem, PA 18018 | 2006-05-12 |
| 1821053141 | Anne Elizabeth Evans | Psychologist | 65 E. Elizabeth Ave., Suite 612, Bethlehem, PA 18018 | 2006-04-19 |
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| 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.