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DR. ANNE NOELLE NISENZON PH.D.
NPI 1578815429
Psychologist - Clinical in Philadelphia, PA

Active since October 02, 2012Opted out of Medicare · through Apr 1, 2027
1528 WALNUT ST STE 1402, PHILADELPHIA, PA 19102(267) 540-8583 Get Directions Write a Review

NPPES record last updated: May 3, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Anne Noelle Nisenzon Ph.d. NPPES

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

DR. ANNE NOELLE NISENZON PH.D. (NPI 1578815429) is an individual clinical provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (PS017791) and active in the NPI registry since October 2012. She has opted out of Medicare through April 1, 2027 and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1578815429
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameDR. ANNE NOELLE NISENZONCredential: PH.D.
Location Address1528 WALNUT ST STE 1402Philadelphia, PA 19102
Mailing Address11 Silver Hill LnVoorhees, NJ 08043-4731 · (609) 332-7530
Phone(267) 540-8583
Sole ProprietorYes
Enumeration DateOctober 2, 2012
Last NPPES UpdateMay 3, 2019
✔ NPI 1578815429 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
Licenses✔ Licensed in PA · PS017791✔ Licensed in CA · 25172
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.
1528 WALNUT ST STE 1402, Philadelphia, PA 19102
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Secondary Practice Locations 2

Location 11528 Walnut St Ste 1402Philadelphia, PA 19102 · Phone (267) 540-8583
Location 21200 W Tabor Rd Ste 100Philadelphia, PA 19141-3019 · Phone (215) 663-6404

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. Anne Noelle Nisenzon Ph.d. 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 April 1, 2023 through April 1, 2027.

Opt-Out Effective DateApril 1, 2023
Opt-Out In Effect ThroughApril 1, 2027Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 2

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

OPTIMAL HEALTH THERAPY LLC
Psychologist (Clinical)
1528 WALNUT ST STE 1402
PHILADELPHIA, PA 19102
Philadelphia County (267) 540-8583
DR. RAWAN NAWAZ D.C
Chiropractor
1528 WALNUT ST STE 1402
PHILADELPHIA, PA 19102
Philadelphia County (215) 309-2380

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 Anne Nisenzon's NPI number?

The NPI number for Anne Nisenzon is 1578815429. It was assigned to this individual provider in the NPPES registry on October 2, 2012.

Where is Anne Nisenzon located?

Anne Nisenzon practices at 1528 Walnut St Ste 1402, Philadelphia, PA 19102. The listed phone number is (267) 540-8583.

What is Anne Nisenzon's specialty?

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

Is Anne Nisenzon enrolled in Medicare?

No. Anne Nisenzon has opted out of Medicare through April 1, 2027. 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 Anne Nisenzon was last updated on May 3, 2019. 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.