Michael Baniewicz, PSY.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

PS018515 Issued in PA

Practice address

1010 W 8TH Ave Ste I
King of Prussia, PA 19406-1349

Phone

(856) 346-0005

NPI assigned

Jan 23, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• CNNH Therapy LLC

  dba NeurAbilities Healthcare

  • Behavior Analyst
  • King of Prussia, PA
  • NPI 1750845327

  Clinical Neuropsychologist

  NPD (past)
• Dragonfly Health Turnersville

  dba Dragonfly Health

  • Family Nurse Practitioner
  • Turnersville, NJ
  • NPI 1477196707
  NPD (past)
• The Center for Neurological and Neurodevelopmental Health, LLC

  dba CNNH

  • Neurology Physician
  • Voorhees, NJ
  • NPI 1962682989
  NPD (past)

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

{
    "created_epoch": "1421971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637539200000",
    "number": "1134519523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 W 8TH AVE STE I",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194061349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 W 8TH AVE STE I",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194061349",
            "telephone_number": "856-346-0005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANIEWICZ",
        "first_name": "MICHAEL",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-23",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC005164",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "PA",
            "license": "PS018515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Balance and Vestibular Center of King of Prussia LLC
• Balboa Pharmacy LLC
• Emma Rose Ball, M.S., CF-SLP
• Matthew James Ballas, DMD
• April Balobalo
• Julianne Baratta, DPT
• Kelly Barber
• India Barcus
• Ruth Celeste Barker-Davis, RN
• Lauren Kathryn Barker

• Clinical Neuropsychologist in King of Prussia, PA
• Providers in King of Prussia, PA by specialty
• Clinical Neuropsychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.