NPIMap

Organization Active NPI

Psych Choices of the Delaware Valley, LLC

  • Professional Counselor
  • Drexel Hill, PA
National Provider Identifier
1194213892
Registry record updated Apr 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
PSYCH CHOICES OF THE DELAWARE VALLEY, LLC
Practice address
5060 State Rd
Drexel Hill, PA 19026-4609
Phone
(610) 626-8085
Fax
(610) 626-8032
NPI assigned
Apr 27, 2018
Last updated
Apr 27, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2018

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

Authorized official

Name
Damani Irby, LPCNPI 1639503154
Title
Owner
Phone
(610) 626-8085

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 6

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X NU Primary
Psychologist 103T00000X NU
Clinical Social Worker 1041C0700X NU
Marriage & Family Therapist 106H00000X NU
Psychiatry Physician 2084P0800X NU
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU

Addresses

Primary practice location

5060 State Rd
Drexel Hill, PA 19026-4609

Mailing address

5060 State Rd
Drexel Hill, PA 19026-4609
Phone (610) 626-8085

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180509000220 PA Part B Supplier - Clinic/Group Practice 9133483688 Receives reassigned benefits from 20 practitioners
Practice locations: Broomall, PA

National Provider Directory

National Provider Directory

Locations

2002 Sproul Rd
Fl 3
Broomall, PA 19008
Phone (610) 626-8085

2002 Sproul Rd
Ste 300
Broomall, PA 19008
Phone (610) 626-8085

5060 State Rd
Drexel Hill, PA 19026
Phone (610) 626-8085

Practitioners & affiliated clinicians

Practitioners 27

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1524787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524787200000",
    "number": "1194213892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5060 STATE RD",
            "city": "DREXEL HILL",
            "state": "PA",
            "postal_code": "190264609",
            "telephone_number": "610-626-8085",
            "fax_number": "610-626-8032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5060 STATE RD",
            "city": "DREXEL HILL",
            "state": "PA",
            "postal_code": "190264609",
            "telephone_number": "610-626-8085",
            "fax_number": "610-626-8032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCH CHOICES OF THE DELAWARE VALLEY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-27",
        "last_updated": "2018-04-27",
        "status": "A",
        "authorized_official_last_name": "IRBY",
        "authorized_official_first_name": "DAMANI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "610-626-8085",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Drexel Hill, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2018; 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.