Individual provider Active NPI

Agnes Vanburen, MA

  • Psychologist
  • Langhorne, PA
National Provider Identifier
1245396563
Registry record updated Apr 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PS006484L Issued in PA
Practice address
13 Summit Square Ctr
Langhorne, PA 19047-1078
Phone
(215) 949-2520
NPI assigned
Dec 29, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PS006484L PA Primary

Addresses

Primary practice location

13 Summit Square Ctr
Langhorne, PA 19047-1078

Mailing address

13 Summit Square Ctr
Langhorne, PA 19047-1078
Phone (215) 949-2520

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
PS006484LPAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712707200000",
    "number": "1245396563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 SUMMIT SQUARE CTR",
            "city": "LANGHORNE",
            "state": "PA",
            "postal_code": "190471078",
            "telephone_number": "215-949-2520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 SUMMIT SQUARE CTR",
            "city": "LANGHORNE",
            "state": "PA",
            "postal_code": "190471078",
            "telephone_number": "215-949-2520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANBUREN",
        "first_name": "AGNES",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-29",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS006484L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Langhorne, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2024; 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.