Organization
SOUTHAMPTON PSYCHIATRIC ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENISE BEARD (OFFICE MANAGER)
(215) 355-2011
Entity
Organization
Contact information
Practice address
1111 STREET RD, SUITE 312, SOUTHAMPTON, PA 18966-4250
(215) 355-2011
(215) 396-1886
Mailing address
1111 STREET RD, SUITE 312, SOUTHAMPTON, PA 18966-4250
(215) 355-2011
(215) 396-1886
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0977468000
IBC
—
01
—
37920
HIGHMARK
—
01
—
779800
HIGHMARK
—
Enumeration date
08/05/2006
Last updated
10/08/2007
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