NPIMap

Organization Active NPI

The Well Red Lion Psychology,P.C.

  • Clinical Psychologist
  • Red Lion, PA
National Provider Identifier
1366864001
Registry record updated Oct 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS017368 Issued in PA
Legal business name
THE WELL RED LION PSYCHOLOGY,P.C.
Practice address
30 E Broadway
Red Lion, PA 17356-1402
Phone
(717) 244-1082
Fax
(717) 244-1064
NPI assigned
Jan 15, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2014

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

Authorized official

Name
Dr. David Haynes-Weller, PSYD
Title
President
Phone
(717) 341-3366

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X PS017368 PA Primary

Addresses

Primary practice location

30 E Broadway
Red Lion, PA 17356-1402

Mailing address

529 Crestwood Dr
Red Lion, PA 17356-9434
Phone (717) 246-6431

National Provider Directory

National Provider Directory

Locations

30 E Broadway
Red Lion, PA 17356
Phone (717) 244-1082

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1389744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412294400000",
    "number": "1366864001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "529 CRESTWOOD DR",
            "city": "RED LION",
            "state": "PA",
            "postal_code": "173569434",
            "telephone_number": "717-246-6431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 E BROADWAY",
            "city": "RED LION",
            "state": "PA",
            "postal_code": "173561402",
            "telephone_number": "717-244-1082",
            "fax_number": "717-244-1064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE WELL RED LION PSYCHOLOGY,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-15",
        "last_updated": "2014-10-03",
        "status": "A",
        "authorized_official_last_name": "HAYNES-WELLER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "717-341-3366",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS017368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Lion, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2014; 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.