NPIMap

Organization Active NPI

Center for Integrative Psychiatry and Neuromodulation, PLLC

Doing business as Axon Psychiatry

  • Psychiatry Physician
  • Narberth, PA
National Provider Identifier
1265031603
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
CENTER FOR INTEGRATIVE PSYCHIATRY AND NEUROMODULATION, PLLC
Doing business as
Axon Psychiatry
Practice address
822 Montgomery Ave Ste 207
Narberth, PA 19072-1946
Phone
(610) 831-4569
Fax
(215) 714-6977
NPI assigned
Oct 17, 2020
Last updated
Jul 22, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
PSYCHIATRIC ASSOCIATES OF PENNSYLVANIAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 22, 2026

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

Authorized official

Name
Dr. Frederick Rhode Stoddard II, MD, PHDNPI 1447384193
Title
Ceo
Phone
(215) 292-4007

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
Psychiatry Physician 2084P0800X Primary

Addresses

Primary practice location

822 Montgomery Ave Ste 207
Narberth, PA 19072-1946

Mailing address

822 Montgomery Ave Ste 207
Narberth, PA 19072-1946
Phone (610) 831-4569

Other practice location 1

3300 Henry Ave Apt 207
Philadelphia, PA 19129-1151
Phone (215) 825-5979

Other practice location 2

216 Mall Blvd Ste 110
King Of Prussia, PA 19406-2923
Phone (267) 458-7560

Other practice location 3

8705 Germantown Ave
Philadelphia, PA 19118-2720
Phone (215) 825-5979

Other names 1

  • Axon Psychiatry Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210421001000 PA Part B Supplier - Clinic/Group Practice 5890103329 Receives reassigned benefits from 9 practitioners
Practice locations: Philadelphia, PA; Narberth, PA; Abington, PA

National Provider Directory

National Provider Directory
Part of
Psychiatric Associates of Pennsylvania

Locations

1369 Old York Rd
Abington, PA 19001
Phone (215) 884-1776

216 Mall Blvd
Ste 110
King of Prussia, PA 19406

822 Montgomery Ave
Ste 207
Narberth, PA 19072
Phone (215) 565-1005

822 Montgomery Ave
Ste 208
Narberth, PA 19072
Phone (215) 565-1005

3300 Henry Ave
Ste 112
Philadelphia, PA 19129
Phone (215) 565-1005

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1602892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784678400000",
    "number": "1265031603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "822 MONTGOMERY AVE STE 207",
            "city": "NARBERTH",
            "state": "PA",
            "postal_code": "190721946",
            "telephone_number": "610-831-4569",
            "fax_number": "215-714-6977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "822 MONTGOMERY AVE STE 207",
            "city": "NARBERTH",
            "state": "PA",
            "postal_code": "190721946",
            "telephone_number": "610-831-4569",
            "fax_number": "215-714-6977"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3300 Henry Ave Apt 207",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191291151",
            "country_code": "US",
            "telephone_number": "215-825-5979",
            "fax_number": "215-714-6977",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "216 Mall Blvd Ste 110",
            "address_purpose": "LOCATION",
            "city": "King Of Prussia",
            "state": "PA",
            "postal_code": "194062923",
            "country_code": "US",
            "telephone_number": "267-458-7560",
            "fax_number": "215-714-6977",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8705 Germantown Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191182720",
            "country_code": "US",
            "telephone_number": "215-825-5979",
            "fax_number": "215-714-6977",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CENTER FOR INTEGRATIVE PSYCHIATRY AND NEUROMODULATION, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PSYCHIATRIC ASSOCIATES OF PENNSYLVANIA",
        "enumeration_date": "2020-10-17",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A",
        "authorized_official_last_name": "STODDARD",
        "authorized_official_first_name": "FREDERICK",
        "authorized_official_middle_name": "RHODE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "215-292-4007",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "MD, PHD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Axon Psychiatry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Narberth, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2026; 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.