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DR. ALISSA BETH JERUD PHD
NPI 1508340720
Psychologist - Clinical in Philadelphia, PA

Active since September 24, 2018Opted out of Medicare · through Jul 25, 2028
4618 HAZEL AVE, PHILADELPHIA, PA 19143(206) 501-8794 Get Directions Write a Review

NPPES record last updated: September 24, 2018. Verified against the NPPES registry weekly; last sync: September 13, 2026.

About Dr. Alissa Beth Jerud Phd NPPES

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

DR. ALISSA BETH JERUD PHD (NPI 1508340720) is an individual clinical provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (PS018588) and active in the NPI registry since September 2018. She has opted out of Medicare through July 25, 2028.

NPPES Registry Identity

NPI1508340720
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameDR. ALISSA BETH JERUDCredential: PHD
Location Address4618 HAZEL AVEPhiladelphia, PA 19143-2104
Mailing Address4618 Hazel AvePhiladelphia, PA 19143-2104 · (206) 501-8794
Phone(206) 501-8794
Sole ProprietorYes
Enumeration DateSeptember 24, 2018
✔ NPI 1508340720 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in PA · PS018588
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
4618 HAZEL AVE, Philadelphia, PA 19143
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Other Names 1

Former Name (1)Alissa Beth Worly

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Alissa Beth Jerud Phd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from July 25, 2020 through July 25, 2028.

Opt-Out Effective DateJuly 25, 2020
Opt-Out In Effect ThroughJuly 25, 2028Opt-out affidavits renew automatically every two years unless cancelled

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Alissa Jerud's NPI number?

The NPI number for Alissa Jerud is 1508340720. It was assigned to this individual provider in the NPPES registry on September 24, 2018. The provider is also known as Alissa Beth Worly.

Where is Alissa Jerud located?

Alissa Jerud practices at 4618 Hazel Ave, Philadelphia, PA 19143. The listed phone number is (206) 501-8794.

What is Alissa Jerud's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Alissa Jerud enrolled in Medicare?

No. Alissa Jerud has opted out of Medicare through July 25, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Alissa Jerud was last updated on September 24, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.