JUDY BRUCKNER PH.D.
NPI 1104924620
Psychologist in Watkinsville, GA

Active since September 20, 2006PECOS EnrolledAccepts Medicare Assignment
1551 JENNINGS MILL RD UNIT 2000B, WATKINSVILLE, GA 30677(706) 316-9095(706) 353-8948 Get Directions Write a Review

NPPES record last updated: January 17, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Judy Bruckner Ph.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JUDY BRUCKNER PH.D. (NPI 1104924620) is an individual psychologist in Watkinsville, Georgia, licensed in Georgia (2174) and active in the NPI registry since September 2006. She is enrolled in Medicare PECOS and is a graduate of Other (1996).

NPPES Registry Identity

NPI1104924620
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameJUDY BRUCKNERCredential: PH.D.
Location Address1551 JENNINGS MILL RD UNIT 2000BWatkinsville, GA 30677-7252
Mailing Address1551 Jennings Mill Rd Unit 2000bWatkinsville, GA 30677-7252 · (706) 316-9095 · Fax (706) 353-8948
Fax(706) 353-8948
Sole ProprietorNo
Medical School CMSOtherGraduated 1996
Enumeration DateSeptember 20, 2006
Last NPPES UpdateJanuary 17, 2023
NPPES CertifiedJanuary 17, 2023
NPI 1104924620 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in GA · 2174
Definition

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

Also ListedPsychologist · CounselingTaxonomy 103TC1900X · License 2174 (GA)
1551 JENNINGS MILL RD UNIT 2000B, Watkinsville, GA 30677

Other Identifiers 1

Other582430452GA · Blue Cross Blue Shield Ga

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Judy Bruckner Ph.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8820068612
PECOS Enrollment IDI20040729000036
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Psychologist
1551 JENNINGS MILL RD UNIT 2000B
WATKINSVILLE, GA 30677
Point of Service
1551 JENNINGS MILL RD UNIT 2000B
WATKINSVILLE, GA 30677
Psychologist (Counseling)
1551 JENNINGS MILL RD UNIT 2000B
WATKINSVILLE, GA 30677
Psychologist (Counseling)
1551 JENNINGS MILL RD UNIT 2000B
WATKINSVILLE, GA 30677
Psychologist
1551 JENNINGS MILL RD UNIT 2000B
WATKINSVILLE, GA 30677

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1104924620, enumerated as an "individual" on September 20, 2006.

The provider is located at 1551 JENNINGS MILL RD UNIT 2000B WATKINSVILLE, GA 30677 and the phone number is (706) 316-9095.

Psychologist with taxonomy code 103T00000X.

The provider might be accepting Accepts: Providence Health Plan, Blue Cross Blue Shield,. Please consult your insurance carrier or call the provider to verify.