Active NPI
Behavioral Advancements of Dubois
- Psychologist
- Dubois, PA
National Provider Identifier
1497928154
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PS007054L
- Legal business name
- BEHAVIORAL ADVANCEMENTS OF DUBOIS
- Practice address
- 105 West Dubois Avenue
Juniata Place Suite B
Dubois, PA 15801 - Phone
- (814) 375-7090
- Fax
- (814) 375-7940
- NPI assigned
- Apr 2, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sean P Garred, M., LPC, CRC
- Title
- Licensed Psychologist
- Phone
- (814) 375-7090
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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PS007054L | PA | Primary |
Addresses
Primary practice location
105 West Dubois Avenue
Juniata Place Suite B
Dubois, PA 15801
Mailing address
105 West Dubois Avenue
Juniata Place Suite B
Dubois, PA 15801
Phone (814) 375-7090
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0017312240003 | Medicaid | PA | |
| 489548 | Other | PA | HIGHMARK BLUE CROSS |
| VC0634 | Other | PA | COMMUNITY CARE BEHAVIORAL |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Psychologist
- Du Bois, PA
- NPI 1316070600
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207094400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1207094400000",
"number": "1497928154",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 WEST DUBOIS AVENUE",
"address_2": "JUNIATA PLACE SUITE B",
"city": "DUBOIS",
"state": "PA",
"postal_code": "15801",
"telephone_number": "814-375-7090",
"fax_number": "814-375-7940"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 WEST DUBOIS AVENUE",
"address_2": "JUNIATA PLACE SUITE B",
"city": "DUBOIS",
"state": "PA",
"postal_code": "15801",
"telephone_number": "814-375-7090",
"fax_number": "814-375-7940"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BEHAVIORAL ADVANCEMENTS OF DUBOIS",
"organizational_subpart": "NO",
"enumeration_date": "2008-04-02",
"last_updated": "2008-04-02",
"status": "A",
"authorized_official_last_name": "GARRED",
"authorized_official_first_name": "SEAN",
"authorized_official_middle_name": "P",
"authorized_official_title_or_position": "LICENSED PSYCHOLOGIST",
"authorized_official_telephone_number": "814-375-7090",
"authorized_official_credential": "M., LPC, CRC"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychologist",
"state": "PA",
"license": "PS007054L",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0017312240003",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK BLUE CROSS",
"identifier": "489548",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMMUNITY CARE BEHAVIORAL",
"identifier": "VC0634",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dubois, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.