Your Vision for Life Psychological Services

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

YOUR VISION FOR LIFE PSYCHOLOGICAL SERVICES

Practice address

8699 W Chester Pike FL 2
Upper Darby, PA 19082-1101

Phone

(215) 631-3230

Fax

(610) 628-6162

NPI assigned

Mar 27, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Andre Steven Watson, PSY. P

Title

Clinical Psychologist

Phone

(216) 631-3230

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1553644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553644800000",
    "number": "1265993778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8699 W CHESTER PIKE FL 2",
            "city": "UPPER DARBY",
            "state": "PA",
            "postal_code": "190821101",
            "telephone_number": "215-631-3230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8699 W CHESTER PIKE FL 2",
            "city": "UPPER DARBY",
            "state": "PA",
            "postal_code": "190821101",
            "telephone_number": "215-631-3230",
            "fax_number": "610-628-6162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUR VISION FOR LIFE PSYCHOLOGICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-27",
        "last_updated": "2019-03-27",
        "status": "A",
        "authorized_official_last_name": "WATSON",
        "authorized_official_first_name": "ANDRE",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "216-631-3230",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY. P"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Upper Darby, PA
• Providers in Upper Darby, PA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2019; 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.