Organization
MEDOP BEHAVIORAL HEALTH ASSOCIATES OF PENNSYLVANIA PC
Active
Parent organization
MEDOPT SERVICES LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDOPT SERVICES LLC
Authorized official
MS. DONNA DOOLEY (CFO)
(800) 370-3651
Entity
Organization
Contact information
Practice address
2595 INTERSTATE DRIVE, SUITE 103, HARRISBURG, PA 17110-9380
(410) 832-2279
(860) 510-0020
Mailing address
55 HATCHETTS HILL RD, OLD LYME, CT 06371-1534
(800) 370-3651
(860) 510-0020
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
—
—
103TC0700X
Clinical Psychologist
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
2084P0805X
Geriatric Psychiatry Physician
—
—
363A00000X
Physician Assistant
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
364SP0809X
Adult Psychiatric/Mental Health Clinical Nurse Specialist
—
—
Other
Enumeration date
10/19/2009
Last updated
08/30/2016
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