NPIMap

Organization Active NPI

Primavera Psychology Associates, P.C.

  • Clinical Psychologist
  • Philadelphia, PA
National Provider Identifier
1306977491
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS004716L Issued in PA
Legal business name
PRIMAVERA PSYCHOLOGY ASSOCIATES, P.C.
Practice address
1015 Chestnut St
Suite 403
Philadelphia, PA 19107-4316
Phone
(215) 625-9770
Fax
(215) 625-9866
NPI assigned
Mar 8, 2007
Last updated
Aug 22, 2020By the provider in NPPES
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. Joseph Peter Primavera III, PH.D.NPI 1669504213
Title
President
Phone
(215) 625-9770

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X PS004716L PA Primary

Addresses

Primary practice location

1015 Chestnut St
Suite 403
Philadelphia, PA 19107-4316

Mailing address

1015 Chestnut St
Suite 403
Philadelphia, PA 19107-4316
Phone (215) 625-9770

Other identifiers 2

IdentifierTypeStateIssuer
0247316000OtherPAMHS NUMBER
7306218OtherPAPROVIDER ID

National Provider Directory

National Provider Directory

Locations

1015 Chestnut St
Ste 403
Philadelphia, PA 19107
Phone (215) 625-9770

Practitioners & affiliated clinicians

Practitioners 1

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": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306977491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 CHESTNUT ST",
            "address_2": "SUITE 403",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074316",
            "telephone_number": "215-625-9770",
            "fax_number": "215-625-9866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 CHESTNUT ST",
            "address_2": "SUITE 403",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074316",
            "telephone_number": "215-625-9770",
            "fax_number": "215-625-9866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMAVERA PSYCHOLOGY ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PRIMAVERA",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "PETER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-625-9770",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS004716L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHS NUMBER",
            "identifier": "0247316000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER ID",
            "identifier": "7306218",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, 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.