Organization Active NPI

Stanley H. Nadulek, PH.D., P.C.

  • Clinical Psychologist
  • Allison Park, PA
National Provider Identifier
1376691774
Registry record updated Jun 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS-005306-L Issued in PA
Legal business name
STANLEY H. NADULEK, PH.D., P.C.
Practice address
4068 Mount Royal Blvd Ste 218
Allison Park, PA 15101-2951
Phone
(412) 487-1710
Fax
(724) 444-3047
NPI assigned
Jan 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2023

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

Authorized official

Name
Dr. Stanley Howard Nadulek, PHDNPI 1932145463
Title
President
Phone
(412) 487-1710

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103T00000X PS-005306-L PA
Clinical PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TC0700X PS-005306-L PA Primary

Addresses

Primary practice location

4068 Mount Royal Blvd Ste 218
Allison Park, PA 15101-2951

Mailing address

4068 Mount Royal Blvd Ste 218
Allison Park, PA 15101-2951
Phone (412) 487-1710

Other identifiers 1

IdentifierTypeStateIssuer
41-001530638MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050406000447 PA Part B Supplier - Clinic/Group Practice 2769439280 Receives reassigned benefits from 1 practitioner
Practice locations: Allison Park, PA

National Provider Directory

National Provider Directory

Locations

4068 Mount Royal Blvd
Ste 218
Allison Park, PA 15101
Phone (412) 487-1710

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": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686268800000",
    "number": "1376691774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4068 MOUNT ROYAL BLVD STE 218",
            "city": "ALLISON PARK",
            "state": "PA",
            "postal_code": "151012951",
            "telephone_number": "412-487-1710",
            "fax_number": "724-444-3047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4068 MOUNT ROYAL BLVD STE 218",
            "city": "ALLISON PARK",
            "state": "PA",
            "postal_code": "151012951",
            "telephone_number": "412-487-1710",
            "fax_number": "724-444-3047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STANLEY H. NADULEK, PH.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A",
        "authorized_official_last_name": "NADULEK",
        "authorized_official_first_name": "STANLEY",
        "authorized_official_middle_name": "HOWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "412-487-1710",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS-005306-L",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS-005306-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41-001530638",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Allison Park, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2023; 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.