Active NPI
Sean Patrick Bresnahan, ED.D.
- Psychologist
- Du Bois, PA
National Provider Identifier
1427304591
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSO16802
- Practice address
- 605 W Washington Ave
Du Bois, PA 15801-1685 - Phone
- (413) 426-2965
- NPI assigned
- Jul 26, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSO16802 | PA | Primary |
Addresses
Primary practice location
605 W Washington Ave
Du Bois, PA 15801-1685
Mailing address
605 W Washington Ave
Du Bois, PA 15801-1685
Phone (413) 426-2965
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSO16802 | PA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1343260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1343260800000",
"number": "1427304591",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "605 W WASHINGTON AVE",
"city": "DU BOIS",
"state": "PA",
"postal_code": "158011685",
"telephone_number": "413-426-2965"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "605 W WASHINGTON AVE",
"city": "DU BOIS",
"state": "PA",
"postal_code": "158011685",
"telephone_number": "413-426-2965"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRESNAHAN",
"first_name": "SEAN",
"middle_name": "PATRICK",
"name_prefix": "Dr.",
"credential": "ED.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-07-26",
"last_updated": "2012-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "PA",
"license": "PSO16802",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Du Bois, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.