Integrative Psychological & Consulting Services

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

INTEGRATIVE PSYCHOLOGICAL & CONSULTING SERVICES

Practice address

1 Bala Ave
Suite 110
Bala Cynwyd, PA 19004-3212

Phone

(267) 252-3449

NPI assigned

Apr 24, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Williametta Simmons, PSY.D.NPI 1639594898

Title

Owner/Psychologist

Phone

(267) 252-3449

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Williametta Simmons, PSY.D/MBA

  • Psychologist
  • Bala Cynwyd, PA
  • NPI 1639594898

  PA

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1398297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398297600000",
    "number": "1104246529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2708 SOCIETY DR",
            "city": "CLAYMONT",
            "state": "DE",
            "postal_code": "197031763",
            "telephone_number": "267-252-3449",
            "fax_number": "267-299-2578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BALA AVE",
            "address_2": "SUITE 110",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190043212",
            "telephone_number": "267-252-3449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE PSYCHOLOGICAL & CONSULTING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-24",
        "last_updated": "2014-04-24",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "WILLIAMETTA",
        "authorized_official_title_or_position": "OWNER/PSYCHOLOGIST",
        "authorized_official_telephone_number": "267-252-3449",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Bala Cynwyd, PA
• Community/Behavioral Health Agency in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2014; 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.