MEDICARE: DR. JENNA LYNN DAMICO PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PS020687	PA

General Provider Information

NPI Number	:	1851242432
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNA LYNN DAMICO PH.D.

Provider Business Mailing Address
First Line	:	1101 E HECTOR ST UNIT 362
Second Line	:
City	:	CONSHOHOCKEN
State	:	PA
Zip	:	19428-2451
Country	:	US
Telephone Number	:	248-462-3224
Fax Number	:

Provider Business Practice Location Address
First Line	:	601 EWING ST STE C2
Second Line	:
City	:	PRINCETON
State	:	NJ
Zip	:	08540-2756
Country	:	US
Telephone Number	:	856-220-9672
Fax Number	:	856-673-0630

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/09/2026
Last Update Date	:	02/09/2026

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