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Contact Information

JESSICA LAX, PSY.D.
10541 DRUMMOND RD
PHILADELPHIA, PA19154
 Phone: 215-612-7573
 Fax: 215-632-6426
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for JESSICA LAX · (Female)

NPI Number 1649615170
Status Active
Credentials PSY.D. (Doctor of Psychology)
Entity Individual
Enumeration date 05/10/2013
Last updated 07/22/2019 - About 7 years ago
Sole proprietor 1 Yes
Identifiers
  • PA License # PS018819
  • PA Medicaid 23-1742920
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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