Healthcare Provider Details

I. General information

NPI: 1619109220
Provider Name (Legal Business Name): JA'NET MACHELLE HOWARD PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2009
Last Update Date: 06/03/2024
Certification Date: 06/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 OLD YORK ROAD UNIT L04
JENKINTOWN PA
19046-2142
US

IV. Provider business mailing address

505 OLD YORK ROAD UNIT L04
JENKINTOWN PA
19046-2142
US

V. Phone/Fax

Practice location:
  • Phone: 215-630-4958
  • Fax: 215-630-4958
Mailing address:
  • Phone: 215-630-4958
  • Fax: 215-630-4958

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number071007599
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number071007599
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number071007599
License Number StateIL
# 4
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS018038
License Number StatePA
# 5
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number071007599
License Number StateIL
# 6
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPS018038
License Number StatePA
# 7
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License NumberPS038018
License Number StateIL
# 8
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License NumberPS018038
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: