Christiana Care Pennsylvania Inc
Organization Active NPI Clinical Psychologist · Chadds Ford, PA
NPI 1194565374 · NPPES record last updated Aug 20, 2024
Key facts
- NPI
- 1194565374
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Psychologist 103TC0700X
- Legal business name
- CHRISTIANA CARE PENNSYLVANIA INC
- Practice address
- 161 Wilmington W Chester Pike
Chadds Ford, PA 19317-9041 - Phone
- (302) 320-2100
- NPI assigned
- May 28, 2024
- Organization subpart
- Yes
- Parent organization (as reported)
- CHRISTIANA CARE PENNSYLVANIA INC
Authorized official
- Name
- Robert W McMurray Jr.
- Title
- Cfo
- Phone
- (302) 623-7362
Other NPIs on the same Medicare enrollment 14
Member organizations 3
Practitioners 13
-
Guenadi Amoachi, MD
-
Melanie Berman, CRNP
-
Lisa Breslow, DO
-
Christopher Hwang, M.D.
-
Jessica L Intintoli, SLP
-
John M Smyles, M.D.
-
Erin W Snyder-Jones, PT, DPT
-
Lindsay Bonnett, MD
-
Thomas Kaysee Chacko, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240918002420 | PA | Part B Supplier - Clinic/Group Practice | 8921549973 |
Receives reassigned benefits from 217 practitioners 14 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Kennett Square, PA; West Grove, PA; Media, PA; Havertown, PA; Glen Mills, PA; Chadds Ford, PA; Broomall, PA |
National Provider Directory
- Part of
- Christiana Care Pennsylvania Inc
Locations
900 W Baltimore Pike
Ste 102
West Grove, PA 19390
Phone (302) 838-3088
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor |
101YM0800X | |||
| Clinical Psychologist |
103TC0700X | Yes | ||
| Clinical Social Worker |
1041C0700X | |||
| Marriage & Family Therapist |
106H00000X | |||
| Psychiatry Physician |
2084P0800X |
Addresses
Primary practice location
161 Wilmington W Chester Pike
Chadds Ford, PA 19317-9041
Mailing address
4000 Nexus Dr Ste E3
Wilmington, DE 19803-3000
Other names
- CCHS Behavioral Health Practice PA
Other providers in Chadds Ford, PA
- Christiana Care Pennsylvania Inc
- Christiana Care Pennsylvania Inc
- Christiana Care Pennsylvania Inc
- Christiana Care Pennsylvania Inc
- Christiana Care Pennsylvania Inc
- Christiana Care Pennsylvania Inc
- Christiana Care Pennsylvania Inc
- Christiana Care Pennsylvania Inc
- Christiana Care Pennsylvania Inc
- Christiana Care Pennsylvania Inc
All providers in Chadds Ford, PA · Clinical Psychologist in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 20, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.