NPIMap

Organization Active NPI

The Pennsylvania State University

Doing business as Psychological Clinic

  • Public Health or Welfare Agency
  • University Park, PA
National Provider Identifier
1386784593
Registry record updated Jan 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
License
327550 Issued in PA
Legal business name
THE PENNSYLVANIA STATE UNIVERSITY
Doing business as
Psychological Clinic
Practice address
337 Moore Building
University Park, PA 16802-3103
Phone
(814) 865-2191
Fax
(814) 863-1331
NPI assigned
Feb 7, 2007
Last updated
Jan 2, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2024

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

Authorized official

Name
Hannah Noel Holsing, CPB, CPMA
Title
Compliance Specialist
Phone
(814) 863-2680

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X 327550 PA Primary
Psychologist 103T00000X NU
Psychiatry Physician 2084P0800X NU

Addresses

Primary practice location

337 Moore Building
University Park, PA 16802-3103

Mailing address

337 Moore Building
University Park, PA 16802-3103
Phone (814) 865-2191

Other identifiers 6

IdentifierTypeStateIssuer
100270742-0041MedicaidPA
50003816OtherPACAPITAL BLUE CROSS
1000740OtherPACOMMUNITY CARE BEHAVIORAL HEALTH
100270742-0042MedicaidPA
1997358OtherPAHIGHMARK BLUE SHIELD
75990OtherPAEVERNORTH/CIGNA

Other names 1

  • Psychological Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050308000633 PA Part B Supplier - Clinic/Group Practice 8426002908 Receives reassigned benefits from 12 practitioners
1 other NPI on this enrollment
Practice locations: University Park, PA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Psu Psych Clinic11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Member organizations 29

Organizations listed as members of this organization in the National Provider Directory.

View all 29

Ownership & related parties

All facility ownership & control disclosures 7

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Penn State Health St JosephReading, PA, CCN 390096 Hospital 5% Or Greater Indirect Ownership Interest (80%) Jul 1, 2015
Penn State Milton S Hershey Medical CenterHershey, PA, CCN 390256 Hospital 5% Or Greater Indirect Ownership Interest (80%) May 9, 2016
Pennsylvania Psychiatric InstituteHarrisburg, PA, CCN 394051 Hospital 5% Or Greater Indirect Ownership Interest (80%) Jul 1, 2023
Penn State Health Holy Spirit Medical CenterCamp Hill, PA, CCN 390004 Hospital 5% Or Greater Indirect Ownership Interest (80%) Nov 1, 2020
Penn State Health Holy Spirit Medical CenterCamp Hill, PA, CCN 39S004 Hospital 5% Or Greater Indirect Ownership Interest (80%) Nov 1, 2020
Penn State Health Hampden Medical CenterEnola, PA, CCN 390336 Hospital 5% Or Greater Indirect Ownership Interest (80%) Jun 18, 2020
Penn State Health Lancaster Medical CenterLancaster, PA, CCN 390339 Hospital 5% Or Greater Indirect Ownership Interest (80%) Jun 18, 2020

Owned or controlled facilities with NPI records 15

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 15

Practitioners & affiliated clinicians

Practitioners 26

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.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704153600000",
    "number": "1386784593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "337 MOORE BUILDING",
            "city": "UNIVERSITY PARK",
            "state": "PA",
            "postal_code": "168023103",
            "telephone_number": "814-865-2191",
            "fax_number": "814-863-1331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "337 MOORE BUILDING",
            "city": "UNIVERSITY PARK",
            "state": "PA",
            "postal_code": "168023103",
            "telephone_number": "814-865-2191",
            "fax_number": "814-863-1331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PENNSYLVANIA STATE UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A",
        "authorized_official_last_name": "HOLSING",
        "authorized_official_first_name": "HANNAH",
        "authorized_official_middle_name": "NOEL",
        "authorized_official_title_or_position": "COMPLIANCE SPECIALIST",
        "authorized_official_telephone_number": "814-863-2680",
        "authorized_official_credential": "CPB, CPMA"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "PA",
            "license": "327550",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100270742-0041",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "50003816",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMUNITY CARE BEHAVIORAL HEALTH",
            "identifier": "1000740",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100270742-0042",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "1997358",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVERNORTH/CIGNA",
            "identifier": "75990",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Psychological Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Psychological Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in University Park, PA

Sources for this page

Verify at the official NPI Registry.