Individual provider Active NPI

Robert Michael Andolina, PH.D.

  • Clinical Psychologist
  • Cranberry TWP, PA
National Provider Identifier
1356478085
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS004396L Issued in PA
Practice address
501 Smith Dr Ste 6
Cranberry TWP, PA 16066-4133
Phone
(724) 776-0350
Fax
(724) 776-5244
NPI assigned
Feb 28, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PS004396L PA Primary

Addresses

Primary practice location

501 Smith Dr Ste 6
Cranberry TWP, PA 16066-4133

Mailing address

501 Smith Dr Ste 6
Cranberry TWP, PA 16066-4133
Phone (724) 776-0350

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
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PS004396LPAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Child and Adolescent Clinical Associates, Inc. Clinical Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356478085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 SMITH DR STE 6",
            "city": "CRANBERRY TWP",
            "state": "PA",
            "postal_code": "160664133",
            "telephone_number": "724-776-0350",
            "fax_number": "724-776-5244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 SMITH DR STE 6",
            "city": "CRANBERRY TWP",
            "state": "PA",
            "postal_code": "160664133",
            "telephone_number": "724-776-0350",
            "fax_number": "724-776-5244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDOLINA",
        "first_name": "ROBERT",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS004396L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cranberry TWP, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.