Individual provider Active NPI

William Steven Rybicki, PHD

  • Clinical Psychologist
  • Media, PA
National Provider Identifier
1104004530
Registry record updated Mar 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS005191L Issued in PA
Practice address
1055 E Baltimore Pike
Suite 303 Delaware County Professional Services
Media, PA 19063
Phone
(610) 892-3800
Fax
(484) 468-1412
NPI assigned
Feb 7, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2009

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 PS005191L PA Primary

Addresses

Primary practice location

1055 E Baltimore Pike
Suite 303 Delaware County Professional Services
Media, PA 19063

Mailing address

1204 Holly Lane
Delaware County Professional Services
Glen Mills, PA 19342
Phone (610) 892-3800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20220708001451 DC Practitioner - Clinical Psychologist 0446338636 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
University of Utah School of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Clinical Psychology Services PCGroup PAC ID 5496718793, 11 clinicians

Practice addresses (Care Compare)

11325 Random Hills Rd
Suite 360
Fairfax, VA 22030-0972
Phone (703) 691-1326

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Psychology Services PC Clinical CurrentSince Apr 12, 2022 Accepting new patients

Locations

11325 Random Hills Rd
Ste 360
Fairfax, VA 22030
Phone (703) 691-1326

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1202342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237939200000",
    "number": "1104004530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1204 HOLLY LANE",
            "address_2": "DELAWARE COUNTY PROFESSIONAL SERVICES",
            "city": "GLEN MILLS",
            "state": "PA",
            "postal_code": "19342",
            "telephone_number": "610-892-3800",
            "fax_number": "484-468-1412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 E BALTIMORE PIKE",
            "address_2": "SUITE 303 DELAWARE COUNTY PROFESSIONAL SERVICES",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "19063",
            "telephone_number": "610-892-3800",
            "fax_number": "484-468-1412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYBICKI",
        "first_name": "WILLIAM",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-07",
        "last_updated": "2009-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS005191L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Media, PA

Sources for this page

Verify at the official NPI Registry.