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Individual

DR. JOAN DORIS JERUCHIM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSY.D.

Contact information

Practice address
2101 MARKET ST UNIT 3203, PHILADELPHIA, PA 19103
(610) 644-7415
(775) 719-4764
Mailing address
2101 MARKET ST UNIT 3203, PHILADELPHIA, PA 19103-1367
(610) 644-7415
(775) 719-4764

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS-008612-L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001661854
HIGHMARK BLUE SHIELD
PA
01
0026111000
IBC - PERSONAL CHOICE
PA
01
1260848
MULTI-PLAN
PA
01
1760255
COMPSYCH BH CORP
PA
01
186977
MANAGED HEALTH NETWORK
PA
01
230139000
IBC - KEYSTONE
PA
01
4335760
AETNA, NON-HMO
PA
01
JE339389
HIGHMARK BS - PA BS
PA
01
P3264689
OXFORD
PA
Enumeration date
03/18/2006
Last updated
07/15/2018
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