Judy Bruckner, PH.D.
NPI 1104924620ActiveIndividual· Psychologist· Watkinsville, GA
Psychologist (PH.D.) in Watkinsville, Georgia, licensed in GA, with an NPI issued in September 2006. Enrolled in Medicare as practitioner - clinical psychologist.
Overview
| NPI | 1104924620 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PH.D. |
| Sole proprietor | No |
| NPI issued | Sep 20, 2006 |
| Last updated in NPPES | Jan 17, 2023 |
| Certified by provider | Jan 17, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist Primary | 103T00000X | 2174 | GA |
| Psychologist, Counseling | 103TC1900X | 2174 | GA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Psychologist (GA) |
|---|
Education and affiliations
| Graduation year | 1996 |
|---|---|
| Medicare specialty | Clinical Psychologist |
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