Individual provider Active NPI

Lindsay Alt St Thomas, PSY.D.

  • Clinical Psychologist
  • Clarks Summit, PA
National Provider Identifier
1093889842
Registry record updated Dec 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS018251 Issued in PA
Practice address
116 Depot St Apt 2
Clarks Summit, PA 18411-1878
Phone
(570) 507-7649
NPI assigned
Nov 20, 2006
Last updated
Dec 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PS018251 PA Primary

Addresses

Primary practice location

116 Depot St Apt 2
Clarks Summit, PA 18411-1878

Mailing address

6 Belle Ter
Covington Township, PA 18424-7809
Phone (570) 507-7649

Other practice location 1

116 Depot St Apt 2
Clarks Summit, PA 18411-1878
Phone (570) 507-7649

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170518002651 PA Practitioner - Clinical Psychologist 2668630807 Reassigns benefits to 1 organization
Practice locations: Clarks Summit, PA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

301 W Grove St
Suite 1K
Clarks Summit, PA 18411-2080
Phone (570) 736-1800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24680CAMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Lasting Wellness LLC Clinical CurrentSince Oct 31, 2019 Accepting new patients
Vericare of California Medical Group Clinical Past Accepting new patients

Locations

301 W Grove St
Ste 1K
Clarks Summit, PA 18411
Phone (570) 736-1800

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545004800000",
    "number": "1093889842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 BELLE TER",
            "city": "COVINGTON TOWNSHIP",
            "state": "PA",
            "postal_code": "184247809",
            "telephone_number": "570-507-7649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 DEPOT ST APT 2",
            "city": "CLARKS SUMMIT",
            "state": "PA",
            "postal_code": "184111878",
            "telephone_number": "570-507-7649"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "116 Depot St Apt 2",
            "address_purpose": "LOCATION",
            "city": "Clarks Summit",
            "state": "PA",
            "postal_code": "184111878",
            "country_code": "US",
            "telephone_number": "570-507-7649",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ST THOMAS",
        "first_name": "LINDSAY",
        "middle_name": "ALT",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2018-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS018251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarks Summit, PA

Sources for this page

Verify at the official NPI Registry.