Organization
N-PSY-T PSYCHOLOGICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL LEE PSYD (CEO)
(215) 991-9066
Entity
Organization
Contact information
Practice address
6327 BURBRIDGE ST, PHILADELPHIA, PA 19144-2505
(215) 991-9066
(215) 991-9062
Mailing address
6327 BURBRIDGE ST, PHILADELPHIA, PA 19144-2505
(215) 991-9066
(215) 991-9062
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW130970
PA
1041C0700X
Clinical Social Worker
SW130970
PA
1041S0200X
School Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1022188680001
—
PA
Enumeration date
03/15/2016
Last updated
06/24/2020
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