DR. JACK PORTER (NPI# 1508874991) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508874991 |
| Entity Type | Individual |
| Full Name | DR. JACK PORTER |
| Credential | EDD |
| Practice Address |
1205 Manoa Rd Wynnewood PA 19096 |
| Practice Telephone | 6106426876 |
| Mailing Telephone | 6106426876 |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | PS000570 | PA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467573626 | Jack Clark Porter | Dentist | 1919 Malvern Ave, Hot Springs, AR 71901-7753 | 2007-04-03 |
| 1780734574 | Jack Porter | Counselor | 3707 E Shields Ave, Fresno, CA 93726-7029 | 2007-01-12 |
| Street Address |
1205 MANOA RD |
| City | WYNNEWOOD |
| State | PA |
| Zip Code | 19096 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831727866 | Jeffrey Glenn Johnston | Hospitalist | Lankenau Medical Center. 100 E Lancaster Ave, Wynnewood, PA 19096 | 2020-03-27 |
| 1326500331 | Maitri Pancholy | Student in an Organized Health Care Education/Training Program | Annenberg Center, G-10, 100 Lancaster Avenue, Wynnewood, PA 19096 | 2019-04-01 |
| 1306355987 | Karie Elizabeth Melton | Social Worker | 250 E Wynnewood Rd E12, Wynnewood, PA 19096 | 2017-09-26 |
| 1518320662 | Kaitlyn Kennard | Surgery | 100 Lancaster Ave Mob South Suite 422, Wynnewood, PA 19096 | 2016-04-05 |
| 1366814675 | Linda Elkins | Counselor | 543 Haverford Rd, Wynnewood, PA 19096 | 2015-10-26 |
| 1619347655 | Tessa Kovick | Registered Nurse | 100 E Lancaster Ave Ste 114, Wynnewood, PA 19096 | 2015-10-02 |
| 1922476415 | Amy Lenrow | Skilled Nursing Facility | 1510 Powder Mill Lane, Wynnewood, PA 19096 | 2015-09-14 |
| 1144602855 | Casey Dajao | Internal Medicine | 100 E Lancaster Ave Ste 140, Wynnewood, PA 19096 | 2015-06-18 |
| 1649666223 | Benjamin Larson | Internal Medicine | 100 E Lancaster Ave Ste B11, Wynnewood, PA 19096 | 2015-04-10 |
| 1760873285 | Kathleen Gilmartin | Nurse Practitioner | 100 East Lancaster Ave, Wynnewood, PA 19096 | 2015-02-06 |
| Find all providers in zip 19096 | ||||
| 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 |
|---|---|---|---|---|
| 1144781055 | Cathryn Ashley Borders | Psychologist | 308 E Lancaster Ave Ste 200, Wynnewood, PA 19096-2145 | 2019-03-26 |
| 1912471350 | Aviva Gaskill, Phd, Pllc | Psychologist | 308 East Lancaster Avenue, Suite 200, Wynnewood, PA 19096-2145 | 2019-01-18 |
| 1053834903 | David Aria Weiman | Psychologist | 333 E Lancaster Ave Ste 202, Wynnewood, PA 19096-1929 | 2017-07-24 |
| 1922422609 | Ruth Tomases Joffe | Psychologist | 1363 Indian Creek Dr, Wynnewood, PA 19096-3321 | 2014-02-14 |
| 1841548377 | Margaret Noel Baker | Psychologist | 1200 Remington Rd, Wynnewood, PA 19096-2330 | 2012-08-15 |
| 1346420676 | Dorothy Jean Burton | Psychologist | 423 Shortridge Dr, Wynnewood, PA 19096-1637 | 2007-11-03 |
| 1245436419 | Thomas Klee | Psychologist | 1419 Westwood Ln, Wynnewood, PA 19096-3838 | 2007-06-25 |
| 1164635413 | Deborah Swirsky-sacchetti | Psychologist | 263 Beech Hill Rd, Wynnewood, PA 19096 | 2007-05-07 |
| 1316032576 | Ernesto Celi Hermosisima | Psychologist | 1 E Wynnewood Rd, Suite 100, Wynnewood, PA 19096 | 2006-10-04 |
| 1740215094 | Ruth A Raymon | Psychologist | 1405 Westwood Lane, 2nd Fl, Wynnewood, PA 19096 | 2006-07-12 |
| Find all providers in WYNNEWOOD | ||||
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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.