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Organization
SPRINGFIELD PSYCHOLOGICAL PC
Active
Organization
SPRINGFIELD PSYCHOLOGICAL PC
Active
Other names
Associates of Springfield Psychological
Organization subpart
No
Provider details
NPI number
Authorized official
ELISABETH PESCE (SECRETARY)
(904) 605-4986
Entity
Organization
Contact information
Practice address
1489 BALTIMORE PIKE, BLDG. 200, SUITE 250, SPRINGFIELD, PA 19064-3958
(610) 544-2110
(610) 604-9510
Mailing address
1489 BALTIMORE PIKE, BLDG. 200, SUITE 250, SPRINGFIELD, PA 19064-3958
(610) 544-2110
(610) 604-9510
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
PS003470-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0261150000
MAGELLAN
PW
01
—
202603000
AETNA
PW
Enumeration date
01/23/2006
Last updated
12/01/2022
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