KEYSTONE PSYCHOLOGICAL ASSOCIATES (NPI# 1154604007) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154604007 |
| Entity Type | Organization |
| Organization Name | KEYSTONE PSYCHOLOGICAL ASSOCIATES |
| Practice Address |
3502 Scotts Lane Building 1 Suite 114 Philadelphia PA 19129 |
| Practice Telephone | 2678479560 |
| Practice Fax Number | 2156893495 |
| Mailing Telephone | 2678479560 |
| Mailing Fax Number | 2156893495 |
| Enumeration Date | 2011-09-27 |
| Last Update Date | 2011-09-27 |
| Authorized Official Name | DR. BRIAN GALLAGHER (LICENSED PSYCHOLOGIST) |
| Authorized Official Telephone | 2678479560 |
| Authorized Official Credential | PSY.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
PS016416 | PA | Ambulatory Health Care Facilities |
| Street Address |
3502 SCOTTS LANE BUILDING 1 SUITE 114 |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19129 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982243754 | Margaret Brown | Social Worker | Sherman Mills 3502 Scott's Lane, Building 16, Philadelphia, PA 19129 | 2019-12-27 |
| 1518325760 | Care365 Inc | Case Management | 3507 Scotts Ln, Ste. 1923, Philadelphia, PA 19129 | 2016-02-03 |
| 1144698408 | Raymond C Nwaneri | Nurse Practitioner | 3301 Scotts Lane, Haven Behavioral Hospital, Philadelphia, PA 19129 | 2015-09-03 |
| 1659748432 | Donna S. Wolf | Social Worker | 3302 Tilden Street, Philadelphia, PA 19129 | 2015-08-27 |
| 1891066619 | Melissa Sayer | Advanced Practice Midwife | 2450 W. Hunting Park Ave, Temple University Health System, Philadelphia, PA 19129 | 2012-01-25 |
| 1174754618 | Clarence B Iszard Jr. | Counselor | 3246 North Bailey Street, Philadelphia, PA 19129 | 2009-07-31 |
| 1487816708 | St.chris Care At Northeast Pediatrics, LLC | Pediatrics | One Falls Center, 3300 Henry Avenue, 4th Floor, Philadelphia, PA 19129 | 2008-06-27 |
| 1740400845 | Sharon L. Young | Psychologist | 3205 Defense Terrace, Abbottsford Family Practice & Counseling, Philadelphia, PA 19129 | 2007-04-30 |
| 1043355621 | Donald Herman Silverman | Dentist | 3405 Warden Drive, Philadelphia, PA 19129 | 2007-02-21 |
| 1285778316 | Intercommunity Action, Inc | Community/Behavioral Health | 3500 Midvale Ave, Phila, PA 19129 | 2007-02-20 |
| Find all providers in zip 19129 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467073924 | Childfirst Services, Inc. | Clinic/Center | 2021 N 63rd St Ste 300, Philadelphia, PA 19151-2609 | 2020-05-06 |
| 1760002000 | Spilove Philadelphia, LLC | Clinic/Center | 1601 Walnut St Ste 1007, Philadelphia, PA 19102-2906 | 2020-04-16 |
| 1144856915 | Text and Online Counseling | Clinic/Center | 3900 City Ave Apt M802, Philadelphia, PA 19131-5701 | 2020-03-12 |
| 1750926028 | Forward Psychotherapy, LLC | Clinic/Center | 100 S Broad St Ste 920, Philadelphia, PA 19110-1016 | 2019-11-11 |
| 1184279598 | Patricia Ventura Lcsw | Clinic/Center | 255 S 17th St Ste 1601, Philadelphia, PA 19103-6216 | 2019-08-03 |
| 1568932085 | Well Tied Knot LLC | Clinic/Center | 6703 Germantown Ave # 210-3, Philadelphia, PA 19119-2109 | 2018-11-27 |
| 1306376280 | Port Richmond Counseling Practices | Clinic/Center | 3110 Aramingo Ave, Suite 1, Philadelphia, PA 19134 | 2017-06-14 |
| 1346621448 | Belmont Behavioral Hospital, LLC | Clinic/Center | 11600 Caroline Rd, Philadelphia, PA 19154-2110 | 2015-06-15 |
| 1720429608 | Raices Pastoral Counseling and Human Development Center, Inc | Clinic/Center | 6001 Colgate St, Philadelphia, PA 19111-6004 | 2013-07-09 |
| 1659658938 | Family Behavioral and Mental Health Center, Inc. | Clinic/Center | 3040 Kensington Ave, Philadelphia, PA 19134-2416 | 2011-11-14 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19129 |
Please comment or provide details below to improve the information on KEYSTONE PSYCHOLOGICAL ASSOCIATES.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.