NORTHSHORE PSYCHOLOGICAL ASSOCIATES, LLC (NPI# 1891786331) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891786331 |
| Entity Type | Organization |
| Organization Name | NORTHSHORE PSYCHOLOGICAL ASSOCIATES, LLC |
| Practice Address |
120 E 2nd St Third Floor Erie PA 16507-1537 |
| Practice Telephone | 8148778013 |
| Practice Fax Number | 8148778007 |
| Mailing Telephone | 8148778013 |
| Mailing Fax Number | 8148778007 |
| Enumeration Date | 2005-11-03 |
| Last Update Date | 2015-02-12 |
| Authorized Official Name | DR. MICHAEL SCHWABENBAUER (PARTNER) |
| Authorized Official Telephone | 8148778013 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 0019240150003 | 05 |
| Street Address |
120 E 2ND ST THIRD FLOOR |
| City | ERIE |
| State | PA |
| Zip Code | 16507-1537 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518961564 | Paul Demjanenko | Internal Medicine | 120 E 2nd St, 2nd Floor, Erie, PA 16507-1537 | 2005-06-08 |
| 1114491958 | Brian David Blair | Nurse Practitioner | 120 E 2nd St, Erie, PA 16507-1537 | 2019-01-15 |
| 1992248934 | Brande Dietrich-mclean | Nurse Practitioner | 120 E 2nd St, 2nd Floor, Erie, PA 16507-1537 | 2016-11-23 |
| 1649722117 | Valerie A Tharp | Physician Assistant | 120 E 2nd St, 2nd Floor, Erie, PA 16507-1537 | 2016-10-31 |
| 1053861856 | Susan Troutner | Psychologist | 120 E 2nd St, Third Floor, Erie, PA 16507-1537 | 2016-10-05 |
| 1487104220 | Christa M Norman | Physician Assistant | 120 E 2nd St, Erie, PA 16507-1537 | 2016-10-05 |
| 1255889481 | Cynthia Ann Chuzie-mcdowell | Nurse Practitioner | 120 E 2nd St, Suite #401, Erie, PA 16507-1537 | 2016-09-16 |
| 1104290915 | Mary Jill Vaillancourt | Registered Nurse | 120 E 2nd St, 2nd Floor, Erie, PA 16507-1537 | 2015-11-17 |
| 1841670155 | Alyssa Drushel | Physician Assistant | 120 E 2nd St, 3rd Floor, Erie, PA 16507-1537 | 2015-06-02 |
| 1558768846 | Abigail Lee Trapp | Physician Assistant | 120 E 2nd St, Erie, PA 16507-1537 | 2014-12-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275198723 | Ram Baboo | Student in an Organized Health Care Education/Training Program | 120 East 2nd Street Upmc Northshore Neurology, 3rd Floor, Erie, PA 16507 | 2019-05-09 |
| 1518431915 | Katrina L Putnam | Social Worker | 101 East Avenue, Erie, PA 16507 | 2019-01-18 |
| 1144712084 | Kathlyn Elise Callenius | Student in an Organized Health Care Education/Training Program | 120 East Second St, 3rd Floor, Erie, PA 16507 | 2018-06-06 |
| 1043707490 | Cecelia Anne Hollands | Counselor | 103 East Ave., Erie, PA 16507 | 2018-04-20 |
| 1336591239 | Zachary Dusckas | Student in an Organized Health Care Education/Training Program | 100 Peach St #400, Orthopaedics & Sports Medicine of Erie, Erie, PA 16507 | 2016-07-05 |
| 1679928329 | Stephanie Libra | Occupational Therapist | 100 Barber Place, Box # 29, Erie, PA 16507 | 2016-05-02 |
| 1821476243 | Colin Macelroy Vroome Jr. | Orthopaedic Surgery | Hand, Microsurgery, Reconstructive Orthopedics, LLP, 300 State St. Suite 205, Erie, PA 16507 | 2015-05-18 |
| 1255742227 | Danoushka Tememe | Psychiatry & Neurology | 120 East Second St., 3rd Floor, Erie, PA 16507 | 2014-05-13 |
| 1811307507 | David Aaron Hammer | Psychiatry & Neurology | 120 E Second Street Upmc North Shore Neurology, 7rd Floor, Erie, PA 16507 | 2014-05-02 |
| 1912330325 | Jeanine Krugger | Pharmacist | 363 East 6th St, Erie, PA 16507 | 2013-08-21 |
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| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477614972 | Donna Lee Ziegler | Clinical Neuropsychologist | 204 W 11th St, Suite A, Erie, PA 16501-1702 | 2006-12-12 |
| 1104928266 | Renata Ellen Harland | Clinical Neuropsychologist | 150 E 8th St, Erie, PA 16501-1269 | 2006-09-01 |
| 1487756052 | Lamar Neal, Psyd P.C. | Clinical Neuropsychologist | 4108 Zuck Rd, Erie, PA 16506-4539 | 2006-09-02 |
| 1568476315 | James Eugene Leri | Clinical Neuropsychologist | 1330 W 26th St Fl 2, Erie, PA 16508-1402 | 2006-07-28 |
| 1467489088 | Lamar J. Neal | Clinical Neuropsychologist | 4108 Zuck Rd, Erie, PA 16506-4539 | 2006-06-27 |
| 1932175171 | Tammy Lynn Kordes | Clinical Neuropsychologist | 120 E 2nd St, Third Floor, Erie, PA 16507-1537 | 2006-02-27 |
| 1265433361 | Lance Alan Besner | Clinical Neuropsychologist | 120 E 2nd St, Suite 348, Erie, PA 16507-1537 | 2005-08-10 |
| 1659377182 | Mark Allen Hogue | Clinical Neuropsychologist | 120 E 2nd St, Third Floor, Erie, PA 16507-1537 | 2005-06-21 |
| 1821093386 | Michael Patrick Schwabenbauer | Clinical Neuropsychologist | 120 E 2nd St, Third Floor, Erie, PA 16507-1537 | 2005-06-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366060220 | Yinka Read | Clinical Neuropsychologist | 1088 W. Baltimore Pike, Healthcare II, Suite 2205, Media, PA 19063 | 2020-07-08 |
| 1821617804 | Fit-minded, LLC | Clinical Neuropsychologist | 101 Forrest Ave, Narberth, PA 19072-2213 | 2020-04-10 |
| 1982238887 | Jesse Matthew Main | Clinical Neuropsychologist | 2150 Harrisburg Pike Fl 2, Lancaster, PA 17601-2644 | 2020-02-28 |
| 1467092312 | Katie Fabius | Clinical Neuropsychologist | 230 S Broad St Ste 1005, Philadelphia, PA 19102-4105 | 2020-01-08 |
| 1972155380 | Community Diagnostic Center for Children | Clinical Neuropsychologist | 160 N Craig St Ste 118, Pittsburgh, PA 15213-2714 | 2019-07-15 |
| 1164995023 | Mindful Neuropsychological Services, PC | Clinical Neuropsychologist | 940 E Haverford Rd Ste 303, Bryn Mawr, PA 19010-3859 | 2019-01-03 |
| 1497231666 | Julie Heier | Clinical Neuropsychologist | Department of Psychiatry 100 N Academy Ave, Danville, PA 17822-1335 | 2018-07-11 |
| 1699266189 | Eran Shlomo Auday | Clinical Neuropsychologist | 100 N Academy Ave Dept Of, Danville, PA 17822-1335 | 2018-05-21 |
| 1275033524 | Carla Towsey | Clinical Neuropsychologist | 200 Corporate Cir, Harrisburg, PA 17110-9796 | 2018-02-13 |
| 1093239824 | Ryan P.j. Stocker | Clinical Neuropsychologist | 135 Cumberland Rd Ste 108, Pittsburgh, PA 15237-5447 | 2017-08-02 |
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| 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.