IndividualActive
Alyce Jackson, PH.D.
NPI 1639372089 · Clinical Psychologist · Philadelphia, PA
Provider details
- NPI number
- 1639372089
- Entity type
- Individual
- Primary specialty
- Clinical PsychologistBehavioral Health & Social Service Providers
- Credential
- PH.D.
- Sex
- Female
- Sole proprietor
- Yes
- License
- PS-006130-L (PA)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Practice location
1616 Walnut St
Suite 910
Philadelphia, PA 19103-5313
Phone: (215) 922-2826
Approximate (ZIP-level) locationGet directions
Mailing address
922 Pine St
Philadelphia, PA 19107-6100
Registry dates
- Enumerated
- 2007-06-05
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.