NPIMap

Organization Active NPI

Brookhaven Center for Counseling and Development

  • Clinical Psychologist
  • Fogelsville, PA
National Provider Identifier
1114069796
Registry record updated Jan 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
P5 5276L Issued in PA
Legal business name
BROOKHAVEN CENTER FOR COUNSELING AND DEVELOPMENT
Practice address
2307 Cove Road
Fogelsville, PA 18051
Phone
(610) 395-3005
Fax
(610) 391-1711
NPI assigned
Feb 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2014

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

Authorized official

Name
Dr. Lowell W Hoffman, PH DNPI 1043389984
Title
Clinical Psychologist
Phone
(610) 395-3005

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TC0700X P5 5276L PA Primary
Clinical PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TC0700X PS 5277 L PA

Addresses

Primary practice location

2307 Cove Road
Fogelsville, PA 18051

Mailing address

PO Box 425
Fogelsville, PA 18051
Phone (610) 395-3005

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131210000693 PA Part B Supplier - Clinic/Group Practice 1658508031 Receives reassigned benefits from 2 practitioners
Practice locations: Allentown, PA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390262400000",
    "number": "1114069796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 425",
            "city": "FOGELSVILLE",
            "state": "PA",
            "postal_code": "18051",
            "telephone_number": "610-395-3005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2307 COVE ROAD",
            "city": "FOGELSVILLE",
            "state": "PA",
            "postal_code": "18051",
            "telephone_number": "610-395-3005",
            "fax_number": "610-391-1711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKHAVEN CENTER FOR COUNSELING AND DEVELOPMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2014-01-21",
        "status": "A",
        "authorized_official_last_name": "HOFFMAN",
        "authorized_official_first_name": "LOWELL",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "610-395-3005",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH D"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "P5 5276L",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS 5277 L",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fogelsville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 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.