NPIMap

Organization Active NPI

Center for Integrated Behavioral Health,LLC

  • Psychologist
  • Bethlehem, PA
National Provider Identifier
1083981104
Registry record updated Jan 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PS016995 Issued in PA
Legal business name
CENTER FOR INTEGRATED BEHAVIORAL HEALTH,LLC
Practice address
1 Bethlehem PLZ
Suite 810
Bethlehem, PA 18018-5754
Phone
(610) 865-4300
NPI assigned
Nov 17, 2011
Last updated
Jan 4, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2012

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

Authorized official

Name
Dr. Philip Pellegrino, PSY.D.NPI 1326204868
Title
Co-Founder/Psychologist
Phone
(215) 715-0820

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PS016995 PA Primary

Addresses

Primary practice location

1 Bethlehem PLZ
Suite 810
Bethlehem, PA 18018-5754

Mailing address

1 Bethlehem PLZ
Suite 810
Bethlehem, PA 18018-5754
Phone (610) 865-4300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120322000371 PA Part B Supplier - Clinic/Group Practice 4183884521 Receives reassigned benefits from 18 practitioners
Practice locations: Bethlehem, PA

National Provider Directory

National Provider Directory

Locations

1 E Broad St
Ste 510
Bethlehem, PA 18018
Phone (610) 865-4300

1 W Broad St
Ste 810
Bethlehem, PA 18018
Phone (610) 417-4966

Practitioners & affiliated clinicians

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.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1321488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325635200000",
    "number": "1083981104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BETHLEHEM PLZ",
            "address_2": "SUITE 810",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180185754",
            "telephone_number": "610-865-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BETHLEHEM PLZ",
            "address_2": "SUITE 810",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180185754",
            "telephone_number": "610-865-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR INTEGRATED BEHAVIORAL HEALTH,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-17",
        "last_updated": "2012-01-04",
        "status": "A",
        "authorized_official_last_name": "PELLEGRINO",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_title_or_position": "CO-FOUNDER/PSYCHOLOGIST",
        "authorized_official_telephone_number": "215-715-0820",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS016995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethlehem, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.