Main Line Affiliates

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

MAIN LINE AFFILIATES

Practice address

1 Radnor Corporate Ctr
Suite 400
Radnor, PA 19087-4515

Phone

(610) 254-1450

NPI assigned

Dec 19, 2006

Last updated

May 18, 2016By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Michael J Buongiorno

Title

Exec. VP & Cfo

Phone

(484) 337-8481

Specialties & licenses 11

Addresses

Other names 1

• Main Line Behavioral Health Affiliates Other name

Locations

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• George Abraham, PC

  • Psychiatry Physician
  • Lafayette Hill, PA
  • NPI 1679552368
  NPD (past)
• Charles A Altman, M.D.

  • Psychiatry Physician
  • Haverford, PA
  • NPI 1922367820
  NPD (past)
• Carol L Armstrong, PH.D., ABPN

  • Clinical Neuropsychologist
  • Philadelphia, PA
  • NPI 1407879430
  NPD (past)
• Rebecca Canna, PSY.D.

  • Psychologist
  • Philadelphia, PA
  • NPI 1184886566
  NPD (past)
• Lisa Cerullo, MSW, MHS

  • Addiction (Substance Use Disorder) Counselor
  • Chester Springs, PA
  • NPI 1205062510
  NPD (past)
• Roel D Compendio, MD

  • Psychiatry Physician
  • Paoli, PA
  • NPI 1902885296
  NPD (past)
• Barbara Elaine Foxman, LCSW

  • Clinical Social Worker
  • Lafayette Hill, PA
  • NPI 1720065667
  NPD (past)
• Susan Fralick-Ball, PSYD, MSN

  • Clinical Psychologist
  • Blue Bell, PA
  • NPI 1053696161

  Clinical Neuropsychologist

  NPD (past)
• David Goodwin, PHD

  • Psychologist
  • Philadelphia, PA
  • NPI 1265512362
  NPD (past)
• Leah Greenwood, PH.D.

  • Psychologist
  • Exton, PA
  • NPI 1790763845
  NPD (past)
• Steven D. Hulcher

  • Psychologist
  • Exton, PA
  • NPI 1255319307
  NPD (past)
• Lisa C Jacobson, PSY.D.

  • Clinical Psychologist
  • Newtown, PA
  • NPI 1982865424
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463529600000",
    "number": "1083777239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 E HAVERFORD RD",
            "address_2": "SUITE 110",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103850",
            "telephone_number": "610-526-8480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 RADNOR CORPORATE CTR",
            "address_2": "SUITE 400",
            "city": "RADNOR",
            "state": "PA",
            "postal_code": "190874515",
            "telephone_number": "610-254-1450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN LINE AFFILIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2016-05-18",
        "status": "A",
        "authorized_official_last_name": "BUONGIORNO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EXEC. VP & CFO",
        "authorized_official_telephone_number": "484-337-8481",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "PA",
            "license": "237078",
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "PA",
            "license": "151081",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Main Line Behavioral Health Affiliates",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Joanne K Linevsky, MD
• Aaron Liu Liu, M.D.
• Nichelle M Logan, PHARMD
• Laurie Lynch, RPH
• Sara Turnbull Maggitti, PSY.D.
• Main Line Health Homecare and Hospice (Main Line Health HomeCare and Hospice - home health)
• Main Line Health Homecare and Hospice (Main Line Health HomeCare & Hospice - home health)
• Main Line Health Homecare and Hospice (Main Line Health HomeCare & Hospice - Hospice)
• Main Line Health Homecare and Hospice (Main Line Health HomeCare & Hospice - home health)
• Main Line Health Laboratories

• Psychiatry Physician in Radnor, PA
• Providers in Radnor, PA by specialty
• Psychiatry Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.