Oak Leaf Psychological Services, LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

License

PS015097 Issued in PA

Legal business name

OAK LEAF PSYCHOLOGICAL SERVICES, LLC

Practice address

1 Davis Rd., Ste. 235
Valley Forge, PA 19482

Phone

(610) 783-5000

Fax

(610) 783-0525

NPI assigned

Aug 19, 2008

Last updated

Aug 19, 2008By 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

Dr. Stephanie M Russo, PSY.D.NPI 1740250034

Title

Clinical Psychologist

Phone

(610) 783-5000

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Stephanie M Russo, PSYD

  • Clinical Psychologist
  • Valley Forge, PA
  • NPI 1740250034
  NPD (past) Authorized official

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

{
    "created_epoch": "1219104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219104000000",
    "number": "1083861330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DAVIS RD., STE. 235",
            "address_2": "PO BOX 35",
            "city": "VALLEY FORGE",
            "state": "PA",
            "postal_code": "194810035",
            "telephone_number": "610-783-5000",
            "fax_number": "610-783-0525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 DAVIS RD., STE. 235",
            "city": "VALLEY FORGE",
            "state": "PA",
            "postal_code": "19482",
            "telephone_number": "610-783-5000",
            "fax_number": "610-783-0525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAK LEAF PSYCHOLOGICAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-19",
        "last_updated": "2008-08-19",
        "status": "A",
        "authorized_official_last_name": "RUSSO",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "610-783-5000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "PA",
            "license": "PS015097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Craig E Lacy, MS, LPC
• Sarah Ann Leboon, M.S.W. L.C.S.W.
• Karen Lightner
• Deanna Meckling-Peruto, MS, NCC
• Donna A Moskal
• Kalpana Patankar, MD, M.AC
• Phoenixville Psychological Associates
• Professional Nursing Services, Inc.
• Stephanie M Russo, PSYD
• Angelika Y Sadar, M.A.

• Adult Mental Health Clinic/Center in Valley Forge, PA
• Providers in Valley Forge, PA by specialty
• Adult Mental Health Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2008; 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.