Organization Active NPI

Vanguard Psychological Associates, P.C.

  • Psychologist
  • Wyndmoor, PA
National Provider Identifier
1194884015
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
0816369 Issued in PA
Legal business name
VANGUARD PSYCHOLOGICAL ASSOCIATES, P.C.
Practice address
620 E. Willow Grove Avenue
Wyndmoor, PA 19038-7949
Phone
(215) 233-4350
Fax
(215) 233-4404
NPI assigned
Dec 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Richard Alan Bergman, PH.D.NPI 1366518037
Title
President
Phone
(215) 233-4350

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 0816369 PA Primary

Addresses

Primary practice location

620 E. Willow Grove Avenue
Wyndmoor, PA 19038-7949

Mailing address

620 E. Willow Grove Avenue
Wyndmoor, PA 19038-7949
Phone (215) 233-4350

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194884015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 E. WILLOW GROVE AVENUE",
            "city": "WYNDMOOR",
            "state": "PA",
            "postal_code": "190387949",
            "telephone_number": "215-233-4350",
            "fax_number": "215-233-4404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 E. WILLOW GROVE AVENUE",
            "city": "WYNDMOOR",
            "state": "PA",
            "postal_code": "190387949",
            "telephone_number": "215-233-4350",
            "fax_number": "215-233-4404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANGUARD PSYCHOLOGICAL ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BERGMAN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-233-4350",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "PA",
            "license": "0816369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyndmoor, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.